Provider Demographics
NPI:1841601457
Name:PIKE, AMANDA ALDERS (PHD, MS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ALDERS
Last Name:PIKE
Suffix:
Gender:F
Credentials:PHD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3339 VIRGINIA ST APT 127
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6028
Mailing Address - Country:US
Mailing Address - Phone:305-767-9949
Mailing Address - Fax:
Practice Address - Street 1:3339 VIRGINIA ST APT 127
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-6028
Practice Address - Country:US
Practice Address - Phone:305-767-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist