Provider Demographics
NPI:1518708650
Name:KNAPP, AMANDA L
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:L
Last Name:KNAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:JEROME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2277 SODA LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-6317
Mailing Address - Country:US
Mailing Address - Phone:775-297-6482
Mailing Address - Fax:775-431-2992
Practice Address - Street 1:2277 SODA LAKE RD
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-6317
Practice Address - Country:US
Practice Address - Phone:775-297-6482
Practice Address - Fax:775-431-2992
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician