Amanda Black, MOT, OTR/L

NPI #1992362818 in Potlatch, Idaho

Provider Information

NPI Number: 1992362818
Entity Type: Individual
Name: Amanda Black, MOT, OTR/L
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: MOT, OTR/L
Enumeration Date: May 27, 2019
Last Updated: Apr 8, 2022

Practice Location

Address: 510 ELM ST
City: Potlatch
State: Idaho
ZIP Code: 83855
Phone: (208) 669-3186

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist - Pediatrics — Pediatrics	225XP0200X
Occupational Therapist	225X00000X	Primary

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