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NPI Code Detail

MEDICARE: AMANDA JOY

MEDICARE: AMANDA JOY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-18-32179CO

General Provider Information

NPI Number : 1265907232
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JOY
Provider Business Mailing Address
First Line : 1879 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7857
Country : US
Telephone Number : 719-227-3939
Fax Number :
Provider Business Practice Location Address
First Line : 1879 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7857
Country : US
Telephone Number : 719-227-3939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2018
Last Update Date : 10/05/2018

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Directions to “ AMANDA JOY ” Practice Location

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