Individual
MISS AMANDA MARIE YOUNGGREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
103 GOSSMAN DRIVE, SOUTHERN PINES, NC 28387
(910) 692-7293
(910) 692-7293
Mailing address
95 COMMUNITY RD, #4, PINEHURST, NC 28374
(843) 599-2677
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7868
NC
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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