Individual
AMANDA PUCELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8840 CYPRESS WATERS BLVD STE 300, COPPELL, TX 75019-4630
(469) 524-1506
Mailing address
265 N MOHLER DR, ANAHEIM, CA 92808-1044
(951) 415-4464
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT20640
CA
225X00000X
Occupational Therapist
OT4249
NM
225X00000X
Occupational Therapist
OT429316
OR
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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