Individual
AMANDA BRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 HORSEBLOCK PL, FARMINGVILLE, NY 11738-1204
(631) 854-2552
Mailing address
86 JEFFERSON AVE, PORT JEFFERSON STATION, NY 11776-3020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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