Provider Demographics
NPI:1699383224
Name:SIGG, AMANDA MARIE (RBT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:SIGG
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4143 COLUMBIA RD STE B
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5405
Mailing Address - Country:US
Mailing Address - Phone:706-755-2785
Mailing Address - Fax:706-755-2783
Practice Address - Street 1:4143 COLUMBIA RD STE B
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5405
Practice Address - Country:US
Practice Address - Phone:706-755-2785
Practice Address - Fax:706-755-2783
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-20-127077106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician