Provider Demographics
NPI:1285856948
Name:LERECHE, AMANDA SCOTT (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:SCOTT
Last Name:LERECHE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3311
Mailing Address - Country:US
Mailing Address - Phone:540-314-0435
Mailing Address - Fax:
Practice Address - Street 1:119 BULIFANTS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5709
Practice Address - Country:US
Practice Address - Phone:757-564-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004493225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist