IndividualActive
Amanda Gibson, OTRL
NPI 1336204932 · Pediatric Occupational Therapist · Normal, IL
Provider details
- NPI number
- 1336204932
- Entity type
- Individual
- Primary specialty
- Pediatric Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTRL
- Sex
- Female
- Sole proprietor
- No
- License
- 056006623 (IL)
Mailing address
595 Basswood Ln
Normal, IL 61761-5749
Registry dates
- Enumerated
- 2006-12-26
- Last updated
- 2011-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.