Provider Demographics
NPI:1548408644
Name:HAIG, AMANDA BETH
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BETH
Last Name:HAIG
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 1:718 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:CANAJOHARIE
Mailing Address - State:NY
Mailing Address - Zip Code:13317-4609
Mailing Address - Country:US
Mailing Address - Phone:518-773-3104
Mailing Address - Fax:
Practice Address - Street 1:718 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:CANAJOHARIE
Practice Address - State:NY
Practice Address - Zip Code:13317-4609
Practice Address - Country:US
Practice Address - Phone:518-773-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014010225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist