Individual
AMANDA MAIRE TASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS-OTR-L
Contact information
Practice address
550 GLENWOOD DR, MOORESVILLE, NC 28115-2876
(704) 664-7494
Mailing address
151 WATERLYNN RIDGE RD, MOORESVILLE, NC 28117-5433
(716) 807-8692
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7340
NC
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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