Individual
AMANDA ELLEN MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLD, OTR/L
Contact information
Practice address
1011 HIGH RIDGE RD, SECOND FLOOR, STAMFORD, CT 06905-1610
(203) 200-7256
(646) 626-7586
Mailing address
1011 HIGH RIDGE RD, SECOND FLOOR, STAMFORD, CT 06905-1610
(203) 200-7256
(646) 626-7586
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
003977
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003977
CONNECTICUT LICENSE
CT
01
—
056.005907
NATIONAL REGISTERED OCCUPATIONAL THERAPIST
—
Enumeration date
06/18/2013
Last updated
06/18/2013
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