Provider Demographics
NPI:1386452399
Name:INDEPENDENT ANYWHERE LLC
Entity type:Organization
Organization Name:INDEPENDENT ANYWHERE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACCESSIBILITY EXPERT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:LA BONTE
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L, BCG
Authorized Official - Phone:541-286-7660
Mailing Address - Street 1:2814 RIVER RD S APT D
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2814 RIVER RD S APT D
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9301
Practice Address - Country:US
Practice Address - Phone:541-602-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty