Individual
MRS. AMANDA JEAN BASTING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
572 US 6, MAHOPAC, NY 10541
(845) 519-2295
Mailing address
103 ROUTE 39 S, SHERMAN, CT 06784-2317
(845) 797-8998
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004650
CT
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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