Healthcare Provider Details

I. General information

NPI: 1073196747
Provider Name (Legal Business Name): AMANDA HOPE DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 OLD DAWSON RD STE 2-168
ALBANY GA
31707-1599
US

IV. Provider business mailing address

3121 N OAK STREET EXT
VALDOSTA GA
31602-1099
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 800-832-9419
  • Fax: 855-859-1671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2827982
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: