Healthcare Provider Details

I. General information

NPI: 1578994992
Provider Name (Legal Business Name): AMANDA ELAINE KOCHAN-DEWEY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA KOCHAN SMITH PSYD

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 S. CEDAR CREST BLVD SUITE 1200
ALLENTOWN PA
18103
US

IV. Provider business mailing address

1255 S. CEDAR CREST BLVD SUITE 1200
ALLENTOWN PA
18103
US

V. Phone/Fax

Practice location:
  • Phone: 610-437-4800
  • Fax: 484-725-6437
Mailing address:
  • Phone: 610-437-4800
  • Fax: 484-725-6437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS017838
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: