Provider Demographics
NPI:1225221344
Name:HAAR, AMANDA DAWN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DAWN
Last Name:HAAR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:DAWN
Other - Last Name:HADRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:4414 S 7TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4304
Mailing Address - Country:US
Mailing Address - Phone:812-299-9281
Mailing Address - Fax:812-299-2142
Practice Address - Street 1:4414 S 7TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4304
Practice Address - Country:US
Practice Address - Phone:812-299-9281
Practice Address - Fax:812-299-2142
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003976A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist