Individual
AMANDA HALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
186 LAKE SHORE DR W, DUNKIRK, NY 14048-1437
(716) 661-1590
Mailing address
200 DUNHAM AVE, JAMESTOWN, NY 14701-2528
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103990
NY
175T00000X
Peer Specialist
NYCPS1833
NY
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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