Individual
AMY DOMINICA SECRET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
218 LAUREL CREEK CT, SPRUCE PINE, NC 28777-3134
(828) 765-7312
Mailing address
600 RIDGE RD, BLAIRSVILLE, GA 30512-3923
(828) 333-1558
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4054
NC
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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