Provider Demographics
NPI:1376616748
Name:BESS-FISHEL, AMANDA YVETTE (DC, RBT)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:YVETTE
Last Name:BESS-FISHEL
Suffix:
Gender:F
Credentials:DC, RBT
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:YVETTE
Other - Last Name:BESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, RBT
Mailing Address - Street 1:5604 TIMBER FALLS CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7116
Mailing Address - Country:US
Mailing Address - Phone:704-771-9556
Mailing Address - Fax:
Practice Address - Street 1:7504 E INDEPENDENCE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-9407
Practice Address - Country:US
Practice Address - Phone:910-400-9013
Practice Address - Fax:888-783-7611
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2325111N00000X
NCRBT-24-388598106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890826VMedicaid
NCU73948Medicare UPIN
NC890826VMedicaid