Provider Demographics
NPI:1740674969
Name:BROWN, AMANDA LEE (MA)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 ORIOLE RD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-2237
Mailing Address - Country:US
Mailing Address - Phone:267-303-7999
Mailing Address - Fax:
Practice Address - Street 1:2612 ORIOLE RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-2237
Practice Address - Country:US
Practice Address - Phone:267-303-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist