Individual
AMANDA BODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GLEN COVE AVE, GLEN COVE, NY 11542-2818
(516) 609-2000
Mailing address
100 GLEN COVE AVE, GLEN COVE, NY 11542-2818
(516) 609-2000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
091102-1
NY
1041C0700X
Clinical Social Worker
Primary
086691-1
NY
Other
Enumeration date
02/26/2014
Last updated
03/27/2018
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