Individual
AMANDA MAULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
391 WASHINGTON ST UNIT 613, BUFFALO, NY 14203-2126
(404) 242-7717
Mailing address
391 WASHINGTON ST UNIT 613, BUFFALO, NY 14203-2126
(404) 242-7717
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
024117
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024117
—
NY
Enumeration date
10/29/2019
Last updated
10/29/2019
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