Provider Demographics
NPI:1912101429
Name:PAJERSKI, AMANDA M (OTR)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:PAJERSKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7818 BIG SKY DR STE 217
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2840
Mailing Address - Country:US
Mailing Address - Phone:608-709-7072
Mailing Address - Fax:608-709-7071
Practice Address - Street 1:7818 BIG SKY DR STE 217
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2840
Practice Address - Country:US
Practice Address - Phone:608-709-7072
Practice Address - Fax:608-709-7071
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009345225X00000X
WI4988-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist