Provider Demographics
NPI:1649017278
Name:MONA, AMANDA (IAYT, ERYT200, RYT50)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MONA
Suffix:
Gender:F
Credentials:IAYT, ERYT200, RYT50
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CHICKADEE DR
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-2503
Mailing Address - Country:US
Mailing Address - Phone:240-375-0774
Mailing Address - Fax:
Practice Address - Street 1:265 SANSBURY RD
Practice Address - Street 2:
Practice Address - City:FRIENDSHIP
Practice Address - State:MD
Practice Address - Zip Code:20758-9713
Practice Address - Country:US
Practice Address - Phone:240-375-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach