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Individual

AMANDA HOLLENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN, LAT,ATC

Contact information

Practice address
321 AUTUMN RIVER RUN, PHILADELPHIA, PA 19128-4355
(267) 908-4825
Mailing address
701 E CATHEDRAL RD STE 45-1483, PHILADELPHIA, PA 19128-2128
(267) 908-4825

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004044
PA
2255A2300X
Athletic Trainer
RT003678
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012689
NY LICENSE NUMBER
NY
01
164010096
IL LICENSE NUMBER
IL
01
2643
AR LICENSE NUMBER
AR
01
DN-0011217
DE LICENSE NUMBER
DE
01
DN004044
PA LICENSE NUMBER
PA
01
DT91014
TX LICENSE NUMBER
TX
01
DX7322
MD LICENSE NUMBER
MD
01
RT003678
PA LICENSE NUMBER
PA
Enumeration date
01/29/2013
Last updated
07/16/2025
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