Individual
AMANDA IVY WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
35 LONGWOOD RD, MIDDLE ISLAND, NY 11953-2045
(631) 924-0008
Mailing address
PO BOX 12, MIDDLE ISLAND, NY 11953-0012
(631) 924-0008
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
133653894
NY
Other
Enumeration date
11/14/2016
Last updated
03/17/2021
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