Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 29 290 369 | PA |
NPI | 1003157827 |
---|---|
Provider Name | Amanda Ashley Biondy |
First Address | Manchester, MD 21102-1856 |
Second Address | Columbia, MD 21046-2534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2013 |
Last Update Date | 20/12/2016 |