Provider Demographics
NPI:1982012027
Name:MATCHETTE, AMANDA SUE (MS, CGC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:SUE
Last Name:MATCHETTE
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MONUMENT RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5060
Mailing Address - Country:US
Mailing Address - Phone:717-741-8166
Mailing Address - Fax:717-741-8638
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 120
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-741-8166
Practice Address - Fax:717-741-8638
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000238170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS