Individual
MRS. AMANDA FLUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
381 SUNRISE HWY STE 602, LYNBROOK, NY 11563-3006
(718) 208-3914
Mailing address
381 SUNRISE HWY STE 602, LYNBROOK, NY 11563-3006
(347) 868-7813
(718) 264-4620
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
074608-1
NY
1041C0700X
Clinical Social Worker
Primary
081057
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184822587
—
NY
Enumeration date
07/06/2007
Last updated
06/24/2021
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