Black, Amanda

Black, Amanda is an sole proprietor health care provider with primary practice located at 510 Elm St , Potlatch ID 83855. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Black, Amanda can be contacted via phone (208) 669-3186.

Contact Information

Primary practice address
510 Elm St Potlatch ID 83855
Phone: (208) 669-3186
Fax: (208) 747-0782
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT-1112 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT-1112 Idaho

Profile Details

NPI number 1992362818
LBN Legal business name Black, Amanda
Credentials MOT, OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2019
Last updated Apr 8th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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