Individual
AMANDA DENHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
791 RINEHART RD # 4876, LAKE MARY, FL 32746
(407) 413-9550
Mailing address
791 RINEHART RD # 4876, LAKE MARY, FL 32746-4876
(407) 413-9550
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
D550-003-96-809-0
FL
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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