Provider Demographics
NPI:1386337459
Name:OSTROFF, AMANDA N (PSYD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:OSTROFF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 GOOCH DRIVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5525
Mailing Address - Country:US
Mailing Address - Phone:757-603-7334
Mailing Address - Fax:
Practice Address - Street 1:240 GOOCH DRIVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:757-603-7334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008072103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling