Individual
AMANDA DANIELLE LUKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
85 LEON WARD RD, PERRY, FL 32347-8959
(850) 843-3591
Mailing address
85 LEON WARD RD, PERRY, FL 32347-8959
(850) 843-3591
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 15397
FL
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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