Individual
AMANDA TANTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 DEVEREUX WAY, RED HOOK, NY 12571-2268
(845) 758-1899
Mailing address
40 DEVEREUX WAY, RED HOOK, NY 12571-2268
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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