IndividualActive
Amanda Povlock, CTRS
NPI 1780159053 · Recreation Therapist · Paw Paw, MI
Provider details
- NPI number
- 1780159053
- Entity type
- Individual
- Primary specialty
- Recreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CTRS
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Behavior Technician106S00000X
Behavioral Health & Social Service Providers
Practice location
43815 40th St
Paw Paw, MI 49079-9673
Phone: (269) 903-6584
Approximate (ZIP-level) locationGet directions
Mailing address
43815 40th St
Paw Paw, MI 49079-9673
Registry dates
- Enumerated
- 2018-10-12
- Last updated
- 2024-04-04
- Certified
- 2024-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.