Individual
AMANDA PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
514 3RD AVE SE, JASPER, FL 32052-6188
(386) 855-4628
Mailing address
514 3RD AVE SE, JASPER, FL 32052-6188
(386) 855-4628
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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