| NPI | 1710386792 |
|---|---|
| Former Name | AMANDA GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CX0006X Rehabilitation Counselor, Orientation and Mobility Training Provider (Licence: SC 6160) |
| Additional Taxonomies | 225CX0006X Rehabilitation Counselor, Orientation and Mobility Training Provider (Licence: FL 6160) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2018-11-05 |