Individual
MS. AMANDA MARTHA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,
Contact information
Practice address
20 CEDAR ST, WORCESTER, MA 01609-2520
(508) 753-5425
(508) 753-9625
Mailing address
20 CEDAR ST, WORCESTER, MA 01609-2520
(508) 753-5425
(508) 753-9625
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303619
—
MA
Enumeration date
11/24/2014
Last updated
11/24/2014
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