Individual
AMANDA DIAN BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 MURRELL RD STE 100, MELBOURNE, FL 32940-6700
(321) 426-7759
(321) 593-0839
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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