Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 13394 | NC |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 13394 | NC |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 13394 | NC |
NPI | 1457958381 |
---|---|
Provider Name | Dr. Amanda Nicole Mcgoye |
First Address | Rock Hill, SC 29732-8070 |
Second Address | Charlotte, NC 28203-5814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2020 |
Last Update Date | 05/10/2020 |