Provider Demographics
NPI:1306600697
Name:FRIAS, AMANDA MARIE (OTD, OTR)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:FRIAS
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 W SHELL AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76501-1647
Mailing Address - Country:US
Mailing Address - Phone:254-718-7868
Mailing Address - Fax:
Practice Address - Street 1:606 W SHELL AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-1647
Practice Address - Country:US
Practice Address - Phone:254-718-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117470225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist