MEDICARE: DR. AMANDA L SCOTT OTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OC009429	PA
2	225X00000X	Occupational Therapist	31003327A	IN

General Provider Information

NPI Number	:	1669696381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA L SCOTT OTRL

Provider Business Mailing Address
First Line	:	10334 NELSON ST
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307-7667
Country	:	US
Telephone Number	:	484-319-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 CHAPEL DR
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-4520
Country	:	US
Telephone Number	:	219-464-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	04/14/2021

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Directions to “ DR. AMANDA L SCOTT OTRL” Practice Location

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