Individual
AMANDA WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6615 W EL CORTEZ PL, PHOENIX, AZ 85083-1835
(949) 230-4074
Mailing address
6615 W EL CORTEZ PL, PHOENIX, AZ 85083-1835
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5785
AZ
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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