Individual
AMANDA ASHLEY BODENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
939 JOHNSON AVE, RONKONKOMA, NY 11779-6066
(631) 471-7242
Mailing address
140 JAYNE AVE, PATCHOGUE, NY 11772-2835
(631) 901-4244
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
106441-1
NY
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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