Healthcare Provider Details

I. General information

NPI: 1578819348
Provider Name (Legal Business Name): AMANDA CHRISTEAN CIURZYNSKI PLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 DUNCAN ST
WARSAW NY
14569-1017
US

IV. Provider business mailing address

39 DUNCAN ST
WARSAW NY
14569-1017
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-0190
  • Fax: 585-786-0196
Mailing address:
  • Phone: 585-786-0190
  • Fax: 585-786-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberP85003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: