Individual
AMANDA LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
380 GRANVILLE ST, GAHANNA, OH 43230-2947
(614) 269-4780
Mailing address
380 GRANVILLE ST, GAHANNA, OH 43230-2947
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT009441
OH
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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