Individual
AMANDA JACKLIN LO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
88 HIGHVIEW AVE, NANUET, NY 10954-3367
(631) 365-4699
Mailing address
88 HIGHVIEW AVE, NANUET, NY 10954-3367
(631) 365-4699
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P139090
NY
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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