Provider Demographics
NPI:1568914489
Name:ZONERAICH, AMANDA KLEIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:KLEIN
Last Name:ZONERAICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:385 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1934
Mailing Address - Country:US
Mailing Address - Phone:201-847-8568
Mailing Address - Fax:
Practice Address - Street 1:385 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1934
Practice Address - Country:US
Practice Address - Phone:201-847-8568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3422103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral