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General NPI Number Information
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NPI Number | 1760835920
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Entity Type | Organization
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Legal Business Name | AMANDA SPERANDIO, LMFT
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 416 HIGHLAND AVE BUILDING B, OFFICE A
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City | CHESHIRE
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State | CT
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Zip | 06410-2527
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Country | US
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Telephone | 203-927-4339
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Fax |
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Provider Business Mailing Address
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Address Line | 323 N COLONY ST APT D
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City | WALLINGFORD
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State | CT
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Zip | 06492-3164
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Country | US
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Telephone | 203-927-4339
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | AMANDA J SPERANDIO
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Credential | LMFT
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Telephone | 203-927-4339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001762
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License Number State | CT
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