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NPI Code Detail

MEDICARE: MRS. AMANDA MARIE KANOUFF MOT OTRL

MEDICARE: MRS. AMANDA MARIE KANOUFF MOT 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
1225X00000XOccupational TherapistOC008216PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2OC008216OTHERPASTATE LICENSE

General Provider Information

NPI Number : 1962626150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA MARIE KANOUFF MOT OTRL
Provider Business Mailing Address
First Line : 227 PLEASANT VALLEY RD
Second Line :
City : JEANNETTE
State : PA
Zip : 15644-4046
Country : US
Telephone Number : 724-853-7093
Fax Number :
Provider Business Practice Location Address
First Line : 80 OLD NEW SALEM RD
Second Line :
City : UNIONTOWN
State : PA
Zip : 15401-8902
Country : US
Telephone Number : 724-438-8416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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