Healthcare Provider Details

I. General information

NPI: 1740195429
Provider Name (Legal Business Name): AMANDA CATHERINE BEAVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 SHARP ST STE 2
HINGHAM MA
02043-4334
US

IV. Provider business mailing address

30 DALE ST
ABINGTON MA
02351-1242
US

V. Phone/Fax

Practice location:
  • Phone: 845-267-0920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2838214
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: