Individual
AMANDA NICOLE HUSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 W TEMPLE ST, LOS ANGELES, CA 90026-4915
(213) 385-5100
Mailing address
1721 GRIFFIN AVE, LOS ANGELES, CA 90031-3312
(323) 810-1062
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21854
CA
Other
Enumeration date
05/18/2020
Last updated
12/01/2020
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