Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 020718 | NY |
Y | 103T00000X | Psychologist | 020718 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 020718 | NY |
NPI | 1083035836 |
---|---|
Provider Name | Mrs. Amanda Sommers James |
First Address | Pittsford, NY 14534 |
Second Address | Pittsford, NY 14534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2013 |
Last Update Date | 17/08/2020 |