Amanda Griffin Wagner, MS, OTR/L
Individual provider Active NPI Occupational Therapist · Colbert, GA
NPI 1154399152 · NPPES record last updated Sep 21, 2018
Key facts
- NPI
- 1154399152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT003237 (GA)
- Practice address
- 11 Charlie Morris Rd BLDG 2
Colbert, GA 30628-2445 - Phone
- (706) 788-2127
- NPI assigned
- Mar 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sundance Rehabilitation Agency, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT003237 | GA | Yes |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | OT003237 | GA |
Addresses
Primary practice location
11 Charlie Morris Rd BLDG 2
Colbert, GA 30628-2445
Mailing address
PO Box 459
Colbert, GA 30628-0459
Phone (706) 788-3234
Other providers in Colbert, GA
- The Hampton House Facility, LLC
- Akilah S Tomingas
- Meredith Udell
- Sydney Voorhees
- Cameron Dean Wagenbrenner
- Danielle Nicole Wilkins Turner
- Jennifer Ruth Wright
All providers in Colbert, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.