Provider Demographics
NPI:1780645218
Name:FLOOD, AMANDA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:FLOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 GUADALCANAL ST
Mailing Address - Street 2:
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-4315
Mailing Address - Country:US
Mailing Address - Phone:805-832-4105
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA-ARORA GROUP JOINT VENTURE
Practice Address - Street 2:903 RUSSELL AVE., 4TH FLOOR
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3282
Practice Address - Country:US
Practice Address - Phone:301-947-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-02
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04101103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical