National Provider Identifier
Amanda Shirley Waller, COTA/L
Amanda Shirley Waller, COTA/L is listed in the NPPES registry with a primary specialty of Occupational Therapy Assistant in Buffalo, NY and a listed phone number of (716) 885-8318.
Profile Overview
- NPI
- 1700122256
- Provider Type
- Individual
- Primary Specialty
- Occupational Therapy Assistant
- Enumeration Date
- January 02, 2013
- Last Updated
- January 02, 2013
Practice Location
- 50 East North Street
- Buffalo, NY 14203
Phone: (716) 885-8318
Mailing Address
- 3119 Smith RD
- Cassadaga, NY 14718-9640
Specialties
- Occupational Therapy Assistant (224Z00000X)
Full Record
- NPI
- 1700122256
- Entity Type
- Individual
- Last Name
- Waller
- First Name
- Amanda
- Middle Name
- Shirley
- Credential
- COTA/L
- Mailing Street Address
- 3119 Smith RD
- Mailing City
- Cassadaga
- Mailing State
- NY
- Mailing ZIP Code
- 14718-9640
- Mailing Country
- US
- Mailing Phone
- (716) 474-5232
- Practice Street Address
- 50 East North Street
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14203
- Practice Country
- US
- Practice Phone
- (716) 885-8318
- Practice Fax
- (716) 885-0229
- Enumeration Date
- January 02, 2013
- Last Updated
- January 02, 2013
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Occupational Therapy Assistant (224Z00000X)