Individual
AMANDA HOLSTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
753 FT. SILL BLVD., LAWTON, OK 73507-1009
(580) 357-6900
Mailing address
413 S BRUCE ST, CARNEGIE, OK 73015-9422
(405) 234-6569
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1125
OK
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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