Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A2607 | MD |
NPI | 1023141538 |
---|---|
Provider Name | Mrs. Amanda Lynn Mccauley |
First Address | Crofton, MD 21114-3238 |
Second Address | Annapolis, MD 21401-7037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |