Individual
MRS. AMANDA MARIE KANOUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT OTRL
Contact information
Practice address
80 OLD NEW SALEM RD, UNIONTOWN, PA 15401-8902
(724) 438-8416
Mailing address
227 PLEASANT VALLEY RD, JEANNETTE, PA 15644-4046
(724) 853-7093
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008216
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018854630003
—
PA
01
—
OC008216
STATE LICENSE
PA
Enumeration date
04/12/2007
Last updated
07/08/2007
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