Provider Demographics
NPI:1326213760
Name:SIMPSON, AMANDA (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:PARISI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:1204 CONNELL DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-3430
Mailing Address - Country:US
Mailing Address - Phone:619-300-6501
Mailing Address - Fax:
Practice Address - Street 1:1201 HEWITT DR
Practice Address - Street 2:SUITE 202
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8833
Practice Address - Country:US
Practice Address - Phone:254-776-7864
Practice Address - Fax:254-776-0775
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT9956320700000X
TX114123225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities