Individual
AMANDA LANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6407 MARTIN ST, CRYSTAL LAKE, IL 60014-4959
(815) 382-2448
Mailing address
6407 MARTIN ST, CRYSTAL LAKE, IL 60014-4959
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
509906
IL
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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