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1235287517
AMANDA STREET
TUPELO, MS
NPI
1235287517
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Former Name
AMANDA RAYBORN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MS OT1818)
Enumeration Date
2007-01-05
Last Update Date
2022-06-08
Business Address
Mrs. AMANDA STREET OT
960 COMMONWEALTH BLVD
TUPELO, MS 38804-9762
Phone number: 662-260-3789
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Mailing Address
Mrs. AMANDA STREET OT
PO BOX 822394
VICKSBURG, MS 39182-2394
Phone number: 601-638-4076
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