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NPI Code Detail

MEDICARE: AMANDA MARTIN MA

MEDICARE: AMANDA MARTIN MA
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
1103T00000XPsychologist097.0135570VT

General Provider Information

NPI Number : 1841156098
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARTIN MA
Provider Business Mailing Address
First Line : 185 TILLEY DR STE 55
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-4484
Country : US
Telephone Number : 802-304-7228
Fax Number :
Provider Business Practice Location Address
First Line : 185 TILLEY DR STE 55
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-4484
Country : US
Telephone Number : 802-304-7228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2025
Last Update Date : 12/31/2025

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Directions to “ AMANDA MARTIN MA” Practice Location

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