Individual
AMANDA KEARNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
97 NEW DORP LN STE D, STATEN ISLAND, NY 10306-2364
(718) 705-7981
Mailing address
477 VERNON AVE, STATEN ISLAND, NY 10309-3044
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
027784-1
—
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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