Individual
AMANDA MALICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1567 OCEAN FRONT ST, SAN DIEGO, CA 92107
(805) 469-5288
Mailing address
1567 OCEAN FRONT ST, SAN DIEGO, CA 92107
(805) 469-5288
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11760
CA
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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