Provider Demographics
NPI:1144695412
Name:RIVERS, AMANDA SUMNER
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SUMNER
Last Name:RIVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WHETSTONE MLS
Mailing Address - Street 2:
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241-1833
Mailing Address - Country:US
Mailing Address - Phone:860-933-7700
Mailing Address - Fax:
Practice Address - Street 1:401 WHETSTONE MLS
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-1833
Practice Address - Country:US
Practice Address - Phone:860-933-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist