Provider Demographics
NPI:1528383734
Name:DEILY, AMANDA CATHERINE
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:CATHERINE
Last Name:DEILY
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 1:551 E STATION AVE
Mailing Address - Street 2:OUTPATIENT PEDIATRICS
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2027
Mailing Address - Country:US
Mailing Address - Phone:484-863-9220
Mailing Address - Fax:610-465-8611
Practice Address - Street 1:551 E STATION AVE
Practice Address - Street 2:OUTPATIENT PEDIATRICS
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-2027
Practice Address - Country:US
Practice Address - Phone:484-863-9220
Practice Address - Fax:610-465-8611
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010833225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist