Provider Demographics
NPI:1295883981
Name:CALHOON, AMANDA LANE (MSOT, OTR L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LANE
Last Name:CALHOON
Suffix:
Gender:F
Credentials:MSOT, OTR L
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LANE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT, OTR L
Mailing Address - Street 1:4100 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5229
Mailing Address - Country:US
Mailing Address - Phone:907-563-8318
Mailing Address - Fax:907-563-3472
Practice Address - Street 1:4100 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 308
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5229
Practice Address - Country:US
Practice Address - Phone:907-563-8318
Practice Address - Fax:907-563-3472
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist