Individual
AMY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 SOUTH A.W. GRIMES BLVD., ROUND ROCK, TX 78664
(512) 310-7665
(512) 310-9228
Mailing address
1250 SOUTH A.W. GRIMES BLVD., ROUND ROCK, TX 78664
(512) 310-7665
(512) 310-9228
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUE CROSS BLUE SHIELD
TX
05
—
0944746-02
—
TX
Enumeration date
02/14/2011
Last updated
02/14/2011
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