Provider Demographics
NPI:1982463899
Name:WOLFSON, AMANDA P (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:P
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BORTOLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5441 N UNIVERSITY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4640
Mailing Address - Country:US
Mailing Address - Phone:954-803-9002
Mailing Address - Fax:954-933-2305
Practice Address - Street 1:5441 N UNIVERSITY DR STE 101
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4640
Practice Address - Country:US
Practice Address - Phone:954-803-9002
Practice Address - Fax:954-933-2305
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist