Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1841638517 |
---|---|
Provider Name | Amanda Victoria Leonard |
First Address | Manhattan, KS 66502-5728 |
Second Address | Manhattan, KS 66502-5728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 04/06/2013 |