Provider Demographics
NPI:1013310689
Name:BLANER, AMANDA JEAN (BA, M ED, ED S)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:JEAN
Last Name:BLANER
Suffix:
Gender:F
Credentials:BA, M ED, ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DEBARTOLO PL STE 220
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6095
Mailing Address - Country:US
Mailing Address - Phone:330-938-2025
Mailing Address - Fax:
Practice Address - Street 1:506 W VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:OH
Practice Address - Zip Code:44672-1151
Practice Address - Country:US
Practice Address - Phone:330-938-2025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3140651251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)