Provider Demographics
NPI:1134813215
Name:HARTKORN, AMANDA D
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:D
Last Name:HARTKORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 PEARL ST APT 607
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4447
Mailing Address - Country:US
Mailing Address - Phone:609-724-6845
Mailing Address - Fax:
Practice Address - Street 1:8829 PEARL ST APT 607
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4447
Practice Address - Country:US
Practice Address - Phone:609-724-6845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst