Individual
AMANDA KOROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2329 NW BOUGAINVILLEA AVE, STUART, FL 34994-9236
(772) 924-4784
Mailing address
2329 NW BOUGAINVILLEA AVE, STUART, FL 34994-9236
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2017
Last updated
05/26/2017
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