Individual
DR. AMANDA MARIE DIVITA WIEMKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2431 SOLOMONS ISLAND RD STE 200, ANNAPOLIS, MD 21401-3730
(410) 757-2077
Mailing address
2431 SOLOMONS ISLAND RD STE 200, ANNAPOLIS, MD 21401-3730
(410) 757-2077
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
06456
MD
Other
Enumeration date
09/15/2020
Last updated
02/21/2022
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