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NPI Code Detail

MEDICARE: AMANDA FLICK

MEDICARE: AMANDA FLICK
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1891386512
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA FLICK
Provider Business Mailing Address
First Line : 20334 RIVER RIDGE TER
Second Line :
City : ASHBURN
State : VA
Zip : 20147-2666
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8000 TOWERS CRESCENT DR FL 13
Second Line :
City : VIENNA
State : VA
Zip : 22182-6211
Country : US
Telephone Number : 833-599-2560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2021
Last Update Date : 01/27/2021

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Directions to “ AMANDA FLICK ” Practice Location

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