Individual
AMANDA KOLLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2641 HAMNER AVE STE 110, NORCO, CA 92860-3637
(626) 536-4834
Mailing address
2641 HAMNER AVE STE 110, NORCO, CA 92860-3637
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11991
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265883128
—
CA
Enumeration date
06/22/2016
Last updated
06/22/2023
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