Provider Demographics
NPI:1346672227
Name:MARTEL, AMANDA J
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:MARTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LIBERTY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3325
Mailing Address - Country:US
Mailing Address - Phone:978-750-6828
Mailing Address - Fax:978-750-6684
Practice Address - Street 1:125 LIBERTY ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3325
Practice Address - Country:US
Practice Address - Phone:978-750-6828
Practice Address - Fax:978-750-6684
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health