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Individual

AMANDA VAUGHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
118 S 6TH ST, ODESSA, DE 19730-2060
(302) 376-4128
Mailing address
932 CADMAN DR, MIDDLETOWN, DE 19709-1528

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
009045-1
NY
224Z00000X
Occupational Therapy Assistant
Primary
U2-0012241
DE

Other

Enumeration date
06/28/2017
Last updated
07/11/2022
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