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Individual

AMANDA CAROLINE SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
120 BELLVIEW AVE, WINCHESTER, VA 22601-3142
(540) 542-0200
Mailing address
20528 BLUEBIRD AVE, HAGERSTOWN, MD 21742-4424
(240) 357-3050

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
12/03/2017
Last updated
12/03/2017
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