Individual
AMANDA WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 CONTINENTE AVE STE 100, BRENTWOOD, CA 94513-7102
(925) 513-2440
Mailing address
144 CONTINENTE AVE STE 100, BRENTWOOD, CA 94513-7102
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18350
CA
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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