Individual
AMANDA KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 RYBAR LN, PALM COAST, FL 32164-6445
(386) 316-3004
Mailing address
23 RYBAR LN, PALM COAST, FL 32164-6445
(386) 316-3004
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111120300
—
FL
Enumeration date
10/15/2021
Last updated
10/15/2021
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