Individual
AMANDA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12100 CHANCELLORS VILLAGE LN, FREDERICKSBURG, VA 22407-6100
(540) 685-0175
Mailing address
10115 MOLLY LN, GLEN ALLEN, VA 23060-4429
(804) 516-4412
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002158
VA
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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