Individual
AMANDA WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 SHORE LN, BAY SHORE, NY 11706-8768
(631) 946-1506
Mailing address
51 SHORE LN, BAY SHORE, NY 11706-8768
(631) 946-1506
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002822
NY
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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