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Individual

AMANDA HASSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
545 VERDAE BLVD, SUITE B, GREENVILLE, SC 29607-4021
(864) 520-8910
(864) 520-8912
Mailing address
545 VERDAE BLVD, SUITE B, GREENVILLE, SC 29607
(864) 520-8910
(864) 520-8912

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4519
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4519
STATE LICENSE
SC
Enumeration date
06/15/2015
Last updated
06/15/2015
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