Provider Demographics
NPI:1598903288
Name:PIERCE, AMANDA MAREK (OTR/L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MAREK
Last Name:PIERCE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1298
Mailing Address - Country:US
Mailing Address - Phone:978-448-4001
Mailing Address - Fax:978-448-4002
Practice Address - Street 1:497 MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1298
Practice Address - Country:US
Practice Address - Phone:978-448-4001
Practice Address - Fax:978-448-4002
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7543225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics