Provider Demographics
NPI:1790457992
Name:CRAFT, AMANDA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:CRAFT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:LINCOLNDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10540-0393
Mailing Address - Country:US
Mailing Address - Phone:914-588-4777
Mailing Address - Fax:914-248-4868
Practice Address - Street 1:17 FLOWER DR
Practice Address - Street 2:
Practice Address - City:LINCOLNDALE
Practice Address - State:NY
Practice Address - Zip Code:10540
Practice Address - Country:US
Practice Address - Phone:914-588-4777
Practice Address - Fax:914-248-4868
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025965225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics