Provider Demographics
NPI:1912258617
Name:GRIEVE, AMANDA JACQUES
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JACQUES
Last Name:GRIEVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 LAKE RIDGE CV
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1223
Mailing Address - Country:US
Mailing Address - Phone:914-584-0900
Mailing Address - Fax:
Practice Address - Street 1:WESTCHESTER INSTITUTE FOR HUMAN DEVELOPMENT
Practice Address - Street 2:CEDAR WOOD HALL ROOM 338
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-1343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator