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General NPI Number Information
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NPI Number | 1083035836
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Entity Type | Individual
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Provider Name | AMANDA SOMMERS JAMES PHD
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Gender | Female
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 90 E MAIN ST APT 3
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City | VICTOR
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State | NY
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Zip | 14564-1440
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Country | US
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Telephone | 585-703-7147
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Fax | 585-486-3034
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Provider Business Mailing Address
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Address Line | 90 E MAIN ST APT 3
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City | VICTOR
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State | NY
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Zip | 14564-1440
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Country | US
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Telephone | 585-703-7147
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Fax | 585-486-3034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 020718
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | P89739
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 020718
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License Number State | NY
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