Individual
AMANDA R PETRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
14 OAK ST APT 2, BRUNSWICK, ME 04011-1980
(914) 424-6713
Mailing address
14 OAK ST APT 2, BRUNSWICK, ME 04011-1980
(914) 424-6713
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT3812
BOARD OF OCCUPATIONAL THERAPY PRACTICE
ME
Enumeration date
06/10/2020
Last updated
08/26/2020
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