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General NPI Number Information
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NPI Number | 1669037784
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Entity Type | Individual
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Provider Name | MRS. AMANDA MARIE CRONIN
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Gender | Female
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 241 GARRISONVILLE RD STE 202
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City | STAFFORD
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State | VA
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Zip | 22554-1555
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Country | US
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Telephone | 703-986-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 155 E 400 S
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2444
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Country | US
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Telephone | 760-975-5162
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BACB497625
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0133001964
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License Number State | VA
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