Individual
AMANDA SHORAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 FAIRFAX RD, SAINT ALBANS, VT 05478-6299
(802) 752-1600
(802) 752-1699
Mailing address
110 FAIRFAX RD, SAINT ALBANS, VT 05478-6299
(802) 752-1600
(802) 752-1699
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072.0107104
VT
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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