Individual
AMY MARTIN FOSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
8991 UNIVERSITY PKWY, UNIT 238, PENSACOLA, FL 32514-9400
(850) 407-4330
(850) 308-5161
Mailing address
8991 UNIVERSITY PKWY APT 238, PENSACOLA, FL 32514-9400
(850) 407-4330
(850) 308-5161
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10504
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT10504
LICENSE
FL
Enumeration date
08/14/2019
Last updated
08/14/2019
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