Individual
AMANDA J. BEVACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
1808 ROUTE 6, CARMEL, NY 10512-2356
(845) 225-2700
(845) 225-3207
Mailing address
1808 ROUTE 6, CARMEL, NY 10512-2356
(845) 225-2700
(845) 225-3207
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2545
NY
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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