Provider Demographics
NPI:1982755492
Name:TROUTMAN, AMANDA T (DO)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:T
Last Name:TROUTMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 S MCCLINTOCK DR STE 212
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5878
Mailing Address - Country:US
Mailing Address - Phone:480-839-5560
Mailing Address - Fax:
Practice Address - Street 1:4025 S MCCLINTOCK DR STE 212
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5878
Practice Address - Country:US
Practice Address - Phone:480-839-5560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry