Individual
MISS AMANDA DENISE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
208 MERCER ROAD, ELIZABETHTOWN, NC 28337
(910) 862-8181
Mailing address
208 MERCER ROAD, ELIZABETHTOWN, NC 28337
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
8821
NC
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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