Amanda Porter, OTR/L

NPI 1639687395 · on the registry since 2018

Practice

Address: 5 Doctors Park Rd
Mount Vernon, IL 62864
Phone: (618) 242-1064
Organisation at this address: Petersen Management Company, Llc
Axiom Gardens Of Mount Vernon Llc
Axiom Gardens Of Mount Vernon Llc
Caravilla Residential Centers, Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 225X00000X
225X00000X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2018-01-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois