Provider Demographics
NPI:1154547081
Name:COLE, AMANDA BARNETT (MS OTRL)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BARNETT
Last Name:COLE
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 MACDONALD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-3850
Mailing Address - Country:US
Mailing Address - Phone:205-467-9638
Mailing Address - Fax:
Practice Address - Street 1:720 MONTCLAIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1964
Practice Address - Country:US
Practice Address - Phone:205-599-4539
Practice Address - Fax:205-599-4535
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2084225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist