Individual
ANDY ANANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5535 S WILLIAMSON BLVD, STE 774, PORT ORANGE, FL 32128-8311
(866) 330-7711
Mailing address
911 STERLING LN, CROWLEY, TX 76036-4626
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
204596
TX
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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