Individual
AMANDA GRACE KENYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
33 KNOLLWOOD DR, ROCKLEDGE, FL 32955-3708
(321) 298-1856
Mailing address
33 KNOLLWOOD DR, ROCKLEDGE, FL 32955-3708
(321) 298-1856
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12444
FL
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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