Individual
MS. AMANDA DURRETTE FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
6361 MAIN ST, GLOUCESTER, VA 23061-5166
(804) 693-2051
Mailing address
6099 T C WALKER RD, GLOUCESTER, VA 23061-4403
(804) 693-7944
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003708
VA
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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