Provider Demographics
NPI:1942705025
Name:SOMANI, AMANDA CHRISTENE (COTA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHRISTENE
Last Name:SOMANI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CHRISTENE
Other - Last Name:SOMANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:334 MOUNT SIDE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-7823
Mailing Address - Country:US
Mailing Address - Phone:803-431-3383
Mailing Address - Fax:
Practice Address - Street 1:301 LEGEND DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8341
Practice Address - Country:US
Practice Address - Phone:803-524-6905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4821224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty