Provider Demographics
NPI:1669000683
Name:QUARLES, AMANDA NICOLE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NICOLE
Last Name:QUARLES
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 1:2855 E MERCED LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-9651
Mailing Address - Country:US
Mailing Address - Phone:803-553-0185
Mailing Address - Fax:
Practice Address - Street 1:2833 S 4TH AVE STE E-1
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8255
Practice Address - Country:US
Practice Address - Phone:928-485-1211
Practice Address - Fax:480-591-9721
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008677225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist