Individual
AMANDA BACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CGC
Contact information
Practice address
1100 WALNUT ST STE 602, PHILADELPHIA, PA 19107-5563
(267) 331-0481
Mailing address
253 S 16TH ST APT 7, PHILADELPHIA, PA 19102-3350
(864) 905-4420
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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