Provider Demographics
NPI:1932975505
Name:MACRAE, AMANDA LYN (MT-BC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LYN
Last Name:MACRAE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GREENBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1952
Mailing Address - Country:US
Mailing Address - Phone:609-346-3995
Mailing Address - Fax:
Practice Address - Street 1:18 W STOW RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3115
Practice Address - Country:US
Practice Address - Phone:609-346-3995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist