Individual
AMANDA HEATHER FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2013 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5307
(850) 391-6060
Mailing address
2013 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5307
(850) 391-6060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21-166705
FL
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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