Provider Demographics
NPI:1285958660
Name:SANCHEZ, AMARYLLIS AMANDA (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:AMARYLLIS
Middle Name:AMANDA
Last Name:SANCHEZ
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 1:60 CLANTOY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2446
Mailing Address - Country:US
Mailing Address - Phone:413-732-8450
Mailing Address - Fax:
Practice Address - Street 1:60 CLANTOY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2446
Practice Address - Country:US
Practice Address - Phone:413-732-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3291224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant