Provider Demographics
NPI:1558249771
Name:ADOMAITIS, AMANDA'LE PAIGE (BA)
Entity type:Individual
Prefix:
First Name:AMANDA'LE
Middle Name:PAIGE
Last Name:ADOMAITIS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:AMANDA'LE
Other - Middle Name:PAIGE
Other - Last Name:BACHRACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 S DOUGLAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4108
Mailing Address - Country:US
Mailing Address - Phone:844-244-1818
Mailing Address - Fax:
Practice Address - Street 1:877 BALTIMORE ANNAPOLIS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4701
Practice Address - Country:US
Practice Address - Phone:844-244-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician