Provider Demographics
NPI:1457114464
Name:MURZ, AMANDA FAITH (RBT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:FAITH
Last Name:MURZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:FAITH
Other - Last Name:PAINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:4143 COLUMBIA RD STE B
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5405
Mailing Address - Country:US
Mailing Address - Phone:706-755-2785
Mailing Address - Fax:706-755-2783
Practice Address - Street 1:4143 COLUMBIA RD STE B
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5405
Practice Address - Country:US
Practice Address - Phone:706-755-2785
Practice Address - Fax:706-755-2783
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-24-325133106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician