Provider Demographics
NPI:1407153117
Name:GARLAND, AMANDA JEANNE
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JEANNE
Last Name:GARLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 SULFRIDGE FARM RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-8510
Mailing Address - Country:US
Mailing Address - Phone:606-878-7256
Mailing Address - Fax:
Practice Address - Street 1:511 SULFRIDGE FARM RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8510
Practice Address - Country:US
Practice Address - Phone:606-878-7256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist