Individual
AMANDA MICHOLYCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4513 OLD VESTAL RD, VESTAL, NY 13850-3571
(607) 323-3067
Mailing address
605 POLLARD HILL RD, JOHNSON CITY, NY 13790-4215
(607) 725-5378
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
00-1491
NY
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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