Provider Demographics
NPI:1104697598
Name:PATRYLAK, AMANDA LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:PATRYLAK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:LYNN
Other - Last Name:PATRYLAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1151 LUCY DR
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2047
Mailing Address - Country:US
Mailing Address - Phone:610-283-3801
Mailing Address - Fax:
Practice Address - Street 1:225 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3143
Practice Address - Country:US
Practice Address - Phone:610-323-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019662225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist