Individual
AMANDA KERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
456 WAVERLY AVE, PATCHOGUE, NY 11772-1586
(631) 447-6460
(631) 289-7098
Mailing address
456 WAVERLY AVE, PATCHOGUE, NY 11772-1586
(631) 447-6460
(631) 289-7098
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111318
NY
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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