Street, Amanda
Street, Amanda is an individual health care provider with primary practice located at 960 Commonwealth Blvd , Tupelo MS 38804-9762. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Street, Amanda can be contacted via phone (662) 260-3789.Contact Information
Primary practice address
960 Commonwealth Blvd
Tupelo MS 38804-9762
Phone: (662) 260-3789
Fax: (662) 260-3790
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT1818 | Mississippi |
Profile Details
| NPI number | 1235287517 |
|---|---|
| LBN Legal business name | Street, Amanda |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Jun 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235287517 | NPPES |
| Mississippi | Other | 000050976 | BCBS |
| Mississippi | MEDICAID | 05037726 | BCBS |
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