Provider Demographics
NPI:1639667918
Name:SCUDJOREK, AMANDA CHRISTINA (PSYD)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:CHRISTINA
Last Name:SCUDJOREK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CHRISTINA
Other - Last Name:JORND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:120 SISTER PIERRE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7521
Mailing Address - Country:US
Mailing Address - Phone:410-575-3061
Mailing Address - Fax:
Practice Address - Street 1:120 SISTER PIERRE DR STE 107
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7521
Practice Address - Country:US
Practice Address - Phone:410-575-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent