Individual
AMANDA REYOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 BLUE HILL AVE, MATTAPAN, MA 02126-2122
(617) 296-0061
(617) 296-5408
Mailing address
1774 BEACON ST, APT. 5, BROOKLINE, MA 02445-2056
(219) 310-6137
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305638
—
MA
Enumeration date
08/21/2012
Last updated
04/03/2015
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