Individual
AMANDA C MICKNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1111 ROCKINGHAM DR, RICHARDSON, TX 75080-4309
(972) 231-8833
Mailing address
7804 SCOTIA DR, DALLAS, TX 75248-3115
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
108175
TX
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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