| NPI | 1134457831 | 
|---|---|
| Former Name | AMANDA ROSE WEIGLE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: NC 7261) | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT 13076) | 
| 225X00000X Occupational Therapist (Licence: TX 113212) | |
| Enumeration Date | 2009-11-18 | 
| Last Update Date | 2021-11-09 |