Individual
AMANDA L DUFOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR
Contact information
Practice address
1001 SERVICE RD, KIEL, WI 53042
(920) 894-2636
(920) 894-1005
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5266-26
WI
225XH1200X
Hand Occupational Therapist
Primary
5266
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027458
—
WI
Enumeration date
12/03/2012
Last updated
09/27/2023
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