Individual
AMANDA RENEE TEATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
890 W 4TH ST, ONTARIO, OH 44906-2565
(419) 774-5520
Mailing address
665 SEQUOIA LN, MANSFIELD, OH 44904-1732
(419) 565-1478
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 007061
OH
Other
Enumeration date
02/25/2008
Last updated
04/27/2017
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