Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA POVLOCK, CTRS
ActiveAMANDA POVLOCK, CTRS is a Recreation Therapist healthcare provider located in PAW PAW, Michigan. NPI 1780159053 is currently active in the NPPES registry. Verify at CMS.
Recreation Therapist · PAW PAW, MI
Registration Details
- NPI Number
- 1780159053
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 12, 2018 (7.8604230568478 yrs)
- Last Updated
- Apr 4, 2024
Practice Information
- Address
-
43815 40TH STPAW PAW, MI, 490799673Browse MI providers · Browse ZIP 49079
- Phone
- 2699036584
- Primary Specialty
-
Recreation Therapist
225800000X
- Additional Specialty
- Behavior Technician
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.