Individual
MISS AMANDA C HETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
78 SOUTH RD, HOLMES, NY 12531-5320
(914) 819-8152
Mailing address
78 SOUTH RD, HOLMES, NY 12531-5320
(914) 819-8152
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
008175-1
NY
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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