Individual
MRS. AMANDA SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7175 COLUMBIA GATEWAY DR, SUITE A, COLUMBIA, MD 21046-2534
(888) 344-5977
Mailing address
417 MACINTOSH CIR, JOPPA, MD 21085-5400
(702) 374-8168
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-15-11476
—
Other
Enumeration date
12/20/2016
Last updated
02/26/2020
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