Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA BLACK, MOT, OTR/L
Active Sole ProprietorOccupational Therapist · POTLATCH, ID
Registration Details
- NPI Number
- 1992362818
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 27, 2019 (6.93662635612 yrs)
- Last Updated
- Apr 8, 2022
- Licenses
-
OT-1112 (ID)OT-1112 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
510 ELM STPOTLATCH, ID, 83855Browse ID providers · Browse ZIP 83855
- Phone
- 2086693186
- Fax
- 2087470782
- Primary Specialty
-
Occupational Therapist
225X00000X
- Additional Specialty
- Occupational Therapist
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.