Individual
MRS. AMANDA MARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1920 GOLDSMITH LN, LOUISVILLE, KY 40218
(502) 594-4013
Mailing address
4120 BOONES GROVE WAY, LOUISVILLE, KY 40299-3495
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R4816
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R4816
KYBOT
KY
Enumeration date
05/26/2015
Last updated
12/12/2022
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