Individual
DR. AMANDA GAIL WHITACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1200 HIGH RIDGE RD, STAMFORD, CT 06905-1223
(203) 580-3595
Mailing address
264 SOUND BEACH AVE APT 2N, OLD GREENWICH, CT 06870-1614
(203) 940-3595
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003916
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2013
Last updated
09/17/2020
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