Provider Demographics
NPI:1154170140
Name:MESSINA, AMANDA ELIZABETH
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:MESSINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SAINT FRANCIS PL
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-5022
Mailing Address - Country:US
Mailing Address - Phone:603-809-6051
Mailing Address - Fax:
Practice Address - Street 1:16 SAINT FRANCIS PL
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-5022
Practice Address - Country:US
Practice Address - Phone:603-809-6051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician