Individual
MS. AMANDA MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
763 BULL RUN, EAGLE, CO 81631-4673
(970) 618-8303
Mailing address
PO BOX 4673, 763 BULL RUN, EAGLE, CO 81631-4673
(970) 618-8303
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2092
CO
225XE0001X
Environmental Modification Occupational Therapist
2092
CO
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
2092
CO
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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