Provider Demographics
NPI:1295012896
Name:CASPER, AMANDA M (MT-BC, NMT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:CASPER
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 W WESTPORT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-1425
Mailing Address - Country:US
Mailing Address - Phone:316-650-0330
Mailing Address - Fax:
Practice Address - Street 1:3914 W WESTPORT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-1425
Practice Address - Country:US
Practice Address - Phone:316-650-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist