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Individual

AMANDA FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
33 MITCHELL AVE, BINGHAMTON, NY 13903-1642
(607) 762-2340
Mailing address
9 BRADLEY ST, OWEGO, NY 13827-1701
(607) 343-9753

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405205
NY

Other

Enumeration date
09/04/2023
Last updated
09/04/2023
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