Healthcare Provider Details

I. General information

NPI: 1609606599
Provider Name (Legal Business Name): AMANDA M CARROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 JEROME DR STE 120
DOVER DE
19901-2513
US

IV. Provider business mailing address

137 JEROME DR STE 120
DOVER DE
19901-2513
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-3280
  • Fax:
Mailing address:
  • Phone: 302-678-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberO3-0000281
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: