Provider Demographics
NPI:1962109769
Name:FALCONE, AMANDA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:FALCONE
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 1:19 LUCIA DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1339
Mailing Address - Country:US
Mailing Address - Phone:781-974-4897
Mailing Address - Fax:
Practice Address - Street 1:19 LUCIA DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1339
Practice Address - Country:US
Practice Address - Phone:781-974-4897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11530225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist