Individual
AMANDA LYNN NEWSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 STATE HIGHWAY 83, DEFUNIAK SPRINGS, FL 32433-7404
(850) 585-9189
(850) 951-0898
Mailing address
40 STATE HIGHWAY 83, DEFUNIAK SPRINGS, FL 32433-7404
(850) 585-9189
(850) 951-0898
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-112588
FL
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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