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General NPI Number Information
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NPI Number | 1831906320
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Entity Type | Individual
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Provider Name | MRS. AMANDA HARTWIG
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Gender | Female
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 46060 MILLSTONE LANDING RD
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-2149
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Country | US
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Telephone | 301-863-4064
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Fax |
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Provider Business Mailing Address
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Address Line | 23160 MOAKLEY ST
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City | LEONARDTOWN
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State | MD
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Zip | 20650-2922
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Country | US
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Telephone | 240-673-6367
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | CER-110325-V0C6V2
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License Number State | MD
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