Provider Demographics
NPI:1215280409
Name:BURCHFIEL, AMANDA (MT-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BURCHFIEL
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MCCONVILLE RD APT 3
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4559
Mailing Address - Country:US
Mailing Address - Phone:703-509-9277
Mailing Address - Fax:
Practice Address - Street 1:300 MCCONVILLE RD APT 3
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4559
Practice Address - Country:US
Practice Address - Phone:703-509-9277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA07662225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist