Individual
AMANDA LYTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1025 NORTHERN BLVD STE 304, ROSLYN, NY 11576-1506
(516) 331-1560
Mailing address
25 MILLFORD DR, LOCUST VALLEY, NY 11560-1224
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
023402
NY
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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