Provider Demographics
NPI:1982580783
Name:MONTGOMERY, AMANDA MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 N HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-1323
Mailing Address - Country:US
Mailing Address - Phone:267-275-6600
Mailing Address - Fax:
Practice Address - Street 1:8100 WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1600
Practice Address - Country:US
Practice Address - Phone:215-576-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant