Individual
AMANDA WILCOX-SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
115 TEAK TRL, BRUNSWICK, GA 31525-4762
(912) 270-7301
Mailing address
115 TEAK TRL, BRUNSWICK, GA 31525-4762
(912) 270-7301
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000580
GA
Other
Enumeration date
10/28/2007
Last updated
10/28/2007
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