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Individual

MRS. AMY E. SOUTHWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3409 CONNECTION RD, FAYETTEVILLE, NC 28311
(910) 488-1816
Mailing address
3708 HEATHER BROOKE DR, FAYETTEVILLE, NC 28306-9718
(910) 423-3635

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3114
NC

Other

Enumeration date
04/17/2009
Last updated
04/17/2009
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