Provider Demographics
NPI:1669858189
Name:AMODIO, RACHEL DAWN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:DAWN
Last Name:AMODIO
Suffix:
Gender:F
Credentials:PSYD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:220 JACK MARTIN BLVD
Mailing Address - Street 2:SUITE E2
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7772
Mailing Address - Country:US
Mailing Address - Phone:732-920-3434
Mailing Address - Fax:732-920-2447
Practice Address - Street 1:220 JACK MARTIN BLVD
Practice Address - Street 2:SUITE E2
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7772
Practice Address - Country:US
Practice Address - Phone:732-920-3434
Practice Address - Fax:732-920-2447
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJTP-143-011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical