Provider Demographics
NPI:1801298641
Name:KLINE, AMANDA (OTR)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:KLINE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 MARK DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-4760
Mailing Address - Country:US
Mailing Address - Phone:267-218-0360
Mailing Address - Fax:
Practice Address - Street 1:265 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2221
Practice Address - Country:US
Practice Address - Phone:215-379-2700
Practice Address - Fax:215-379-2422
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013536225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology