Individual
AMANDA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1022 PRESIDENTIAL CORRIDOR, CALDWELL, TX 77836-4611
(979) 567-0920
Mailing address
706 ACADEMY ST, BRYAN, TX 77803-4964
(979) 574-6343
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213556
TX
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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