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Individual

AMANDA GRAHAM SPAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
2122 AIRLINE DR STE 200, BOSSIER CITY, LA 71111-3270
(318) 828-1450
Mailing address
670 ALBEMARLE DR STE 1100, SHREVEPORT, LA 71106-5947
(318) 828-1450

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200091
LA

Other

Enumeration date
09/26/2023
Last updated
09/26/2023
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