Individual
AMY LYNNE MANTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
80 CECILE ST, AGAWAM, MA 01001-1609
(413) 789-3089
Mailing address
80 CECILE ST, AGAWAM, MA 01001-1609
(413) 789-3089
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
S56905876
MA
Other
Enumeration date
06/29/2012
Last updated
06/29/2012
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