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1063995934
AMANDA JEAN BASTING
MAHOPAC, NY
NPI
1063995934
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: CT 004650)
Enumeration Date
2018-09-07
Last Update Date
2018-09-07
Business Address
Mrs. AMANDA JEAN BASTING M.S. CCC-SLP
572 US 6
MAHOPAC, NY 10541
Phone number: 845-519-2295
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Mailing Address
Mrs. AMANDA JEAN BASTING M.S. CCC-SLP
103 ROUTE 39 S
SHERMAN, CT 06784-2317
Phone number: 845-797-8998
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