Individual
AMANDA GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1778 FOUNTAIN DR, RESTON, VA 20190-3390
(571) 926-9398
Mailing address
21241 CRAB ORCHARD CT, ASHBURN, VA 20147-4905
(703) 629-7513
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003787
VA
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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