Individual
AMANDA MARIE KOTOLSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190029
BLUE CROSS BLUE SHIELD
FL
01
—
743501
UHC OPTUM HEALTH
FL
05
—
812350100
—
FL
05
—
891186000
—
FL
01
—
Z113T
BCBS FL
—
Enumeration date
01/11/2007
Last updated
11/01/2015
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