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Individual

AMANDA M DISTASIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
111 COUNTY CIR, MIDDLESEX BLDG, AMHERST, MA 01003-9255
(413) 545-2337
(413) 545-9602
Mailing address
111 COUNTY CIR, MIDDLESEX BLDG, AMHERST, MA 01003-9255
(413) 545-2337
(413) 545-9602

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
021930
NY
103TC1900X
Counseling Psychologist
11228
MA

Other

Enumeration date
09/03/2010
Last updated
05/03/2023
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