Individual
MRS. AMANDA KAY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
110 N ARBOR PARK, LOUISVILLE, KY 40214-2711
(502) 724-8108
Mailing address
110 N ARBOR PARK, LOUISVILLE, KY 40214-2711
(502) 724-8108
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A4719
KY
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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