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NPI Code Detail

MEDICARE: AMANDA YI SON

MEDICARE: AMANDA YI SON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194390088
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA YI SON
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-854-1116
Fax Number : 305-846-9711
Provider Business Practice Location Address
First Line : 9140 GUILFORD RD STE O
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-2584
Country : US
Telephone Number : 844-244-1818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2021
Last Update Date : 05/24/2021

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Directions to “ AMANDA YI SON ” Practice Location

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