Individual
AMANDA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 308-5117
Mailing address
1005 HILLTOP LANE, SUMMIT, MS 39666
(601) 250-4815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2003
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03676831
—
MS
01
—
OT2003
MS STATE BOARD
MS
Enumeration date
05/10/2007
Last updated
11/02/2021
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