Provider Demographics
NPI:1194930446
Name:MILLER, AMANDA (OTR)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:CAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 MAGAZINE CT
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-6263
Mailing Address - Country:US
Mailing Address - Phone:662-801-7271
Mailing Address - Fax:
Practice Address - Street 1:33 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-4024
Practice Address - Country:US
Practice Address - Phone:304-598-6127
Practice Address - Fax:304-974-3591
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2380225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist