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Individual

AMANDA ELLEN CAMPO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS OTR/L

Contact information

Practice address
4113 GATEWAY DR, COLLEYVILLE, TX 76034-5609
(817) 793-7764
Mailing address
2428 MONTE CARLO WAY, APT 625, FORT WORTH, TX 76244-1487
(631) 965-2589

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
017786
NY
225X00000X
Occupational Therapist
Primary
117332
TX

Other

Enumeration date
01/18/2013
Last updated
01/29/2017
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