Provider Demographics
NPI:1265607287
Name:AMDUR, JANET
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:AMDUR
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 1:19 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 MOORE ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02418
Practice Address - Country:US
Practice Address - Phone:617-993-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2022-03-22
Deactivation Date:2010-11-24
Deactivation Code:
Reactivation Date:2018-03-09
Provider Licenses
StateLicense IDTaxonomies
MA107954104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker