Provider Demographics
NPI:1386976652
Name:ITURRIAGA, AMANDA (MS)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ITURRIAGA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DIGITAL DR
Mailing Address - Street 2:SUITE R
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 DIGITAL DR
Practice Address - Street 2:SUITE R
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2274
Practice Address - Country:US
Practice Address - Phone:410-609-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS