Individual
AMANDA EILEEN WEIDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCC
Contact information
Practice address
333 PARK AVE S, 3D, NEW YORK, NY 10010-2906
(212) 388-1903
Mailing address
195 DRIGGS AVE, 4B, BROOKLYN, NY 11222-4624
(937) 219-3446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/02/2008
Last updated
12/15/2009
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