Provider Demographics
NPI:1740990571
Name:MORIN, AMANDA (MA, CAS, NCSP, ABSNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MORIN
Suffix:
Gender:F
Credentials:MA, CAS, NCSP, ABSNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:MURGIDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CAS, NCSP, ABSNP
Mailing Address - Street 1:187 OLD WILTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW IPSWICH
Mailing Address - State:NH
Mailing Address - Zip Code:03071-3426
Mailing Address - Country:US
Mailing Address - Phone:610-207-2500
Mailing Address - Fax:
Practice Address - Street 1:171 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:NEW IPSWICH
Practice Address - State:NH
Practice Address - Zip Code:03071-3525
Practice Address - Country:US
Practice Address - Phone:603-878-4387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool