Individual
DR. AMANDA COLLEEN PAULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD MS
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001501
VA
152WC0802X
Corneal and Contact Management Optometrist
0618001501
VA
152WV0400X
Vision Therapy Optometrist
0618001501
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618001501
LICENSE
VA
01
—
11558617
UNIVERSAL CREDENTIALING
VA
Enumeration date
06/15/2006
Last updated
03/07/2023
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