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Individual

AMANDA ROSE MODROVSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1160 MONTGOMERY BLVD APT 4411, ALLEN, TX 75013-2770
(905) 868-2603
Mailing address
1160 MONTGOMERY BLVD APT 4411, ALLEN, TX 75013-2770
(905) 868-2603

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-25162
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-17-25162
BEHAVIORAL ABALYST CERTIFICATION BOARD
FL
Enumeration date
09/03/2019
Last updated
09/03/2019
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