Individual
AMANDA AJELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
83 E MAIN ST, BAY SHORE, NY 11706-8305
(631) 666-5067
Mailing address
83 E MAIN ST, BAY SHORE, NY 11706-8305
(631) 666-5067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NY
Other
Enumeration date
01/22/2017
Last updated
09/23/2019
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