Individual
AMANDA FENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5906 N BRANCH AVE, TAMPA, FL 33604-6702
(646) 942-8451
Mailing address
5906 N BRANCH AVE, TAMPA, FL 33604-6702
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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