Amanda M Clark, BCBA
Individual provider Active NPI Behavior Analyst · Windsor, VT
NPI 1346746153 · NPPES record last updated Apr 7, 2021
Key facts
- NPI
- 1346746153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 146.0134209 (VT)
- Practice address
- 147 Main St
Windsor, VT 05089-1338 - Phone
- (802) 674-4428
- NPI assigned
- Apr 2, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.0134209 | VT | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0-18-8495 | VT | |
| Behavior Analyst | 103K00000X | 146.0134209 | VT | Yes |
Addresses
Primary practice location
147 Main St
Windsor, VT 05089-1338
Mailing address
147 Main St
Windsor, VT 05089-1338
Phone (802) 674-4428
Other providers in Windsor, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.