Individual
AMANDA L LANNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-08-4175
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS016390
PA
103TS0200X
School Psychologist
Primary
PS016390
PA
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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