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Individual
AMANDA RAE SQUARE
Active
Individual
AMANDA RAE SQUARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
050057
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D0080907
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084D0003X
—
CT
Enumeration date
06/27/2008
Last updated
06/26/2026
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