Amanda M Thrall, MS,OTR/L

Individual provider Active NPI Pediatric Occupational Therapist · Brewerton, NY

NPI 1467765008 · NPPES record last updated Jul 25, 2010

Key facts

NPI
1467765008
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
015270-1 (NY)
Practice address
9558 Neva LN
Brewerton, NY 13029-9750
Phone
(315) 396-6409
NPI assigned
Jul 25, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
015270-1NYMDPediatric Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 015270-1 NY Yes

Addresses

Primary practice location

9558 Neva LN
Brewerton, NY 13029-9750

Mailing address

9558 Neva LN
Brewerton, NY 13029-9750
Phone (315) 396-6409

Other providers in Brewerton, NY

All providers in Brewerton, NY · Pediatric Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.