Amanda Fairbanks OTR/L
Occupational Therapist in Grand Rapids, MI(View on Map)
Full Name
Amanda Fairbanks OTR/L
NPI Number
1316433576
NPI Type
Individual Provider
Gender
Female
Enumeration Date
07/10/2018
Specialties
(Taxonomies)Licenses
State
Michigan
License Number
5201008519
Contact
Information
Purpose
Mailing
Location
Address
7941 KINMONT CT
1050 4 MILE RD NW
City
Jenison
Grand Rapids
State
MI
MI
Postal Code
49428-9109
49544-1505
Country
US
US
Telephone Number
N/A
(616) 685-7073
Identifiers
Identifier
5201008519
Identifier State
MI
Identifier Issuer
OCCUPATIONAL THERAPY STATE LICENSURE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/10/2018
Provider Address
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