Individual
AMANDA BERTOLOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
5 SQUIRES AVE, PORT JEFFERSON STATION, NY 11776-4324
(631) 905-7460
Mailing address
5 SQUIRES AVE, PORT JEFFERSON STATION, NY 11776-4324
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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