Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 7650 | NC |
NPI | 1063667186 |
---|---|
Provider Name | Amanda L Nehilla |
First Address | Wake Forest, NC 27587-5369 |
Second Address | Garner, NC 27529-8355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 07/02/2014 |