Provider Demographics
NPI:1558060970
Name:SABINS, AMANDA GRACE
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:GRACE
Last Name:SABINS
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 1:212 MYRON RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-1226
Mailing Address - Country:US
Mailing Address - Phone:607-329-6032
Mailing Address - Fax:
Practice Address - Street 1:101 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-5028
Practice Address - Country:US
Practice Address - Phone:607-329-6032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker