Provider Demographics
NPI:1649920133
Name:WOLSKI, AMANDA KATHERINE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATHERINE
Last Name:WOLSKI
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 1:4315 GOLF CLUB DR APT 1406
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5850
Mailing Address - Country:US
Mailing Address - Phone:630-414-1043
Mailing Address - Fax:
Practice Address - Street 1:2204 OGLETREE VILLAGE LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-2965
Practice Address - Country:US
Practice Address - Phone:334-209-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5823225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist