Individual
AMANDA ELISE GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR, CHT
Contact information
Practice address
3650 BERRYHILL RD, PACE, FL 32571-8321
(850) 995-1364
Mailing address
3650 BERRYHILL RD, PACE, FL 32571-8321
(850) 995-1364
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT12484
FL
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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