Gray, Amanda Lynn

Gray, Amanda Lynn is an sole proprietor health care provider with primary practice located at 2202 Mandarin Loop , Dundee FL 33838-4387. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Agencies / Community/Behavioral Health. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Gray, Amanda Lynn can be contacted via phone (833) 869-2423.

Contact Information

Primary practice address
2202 Mandarin Loop Dundee FL 33838-4387
Phone: (833) 869-2423
Fax: (863) 869-6727
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X Florida
Agencies / Community/Behavioral Health 251S00000X Florida
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-21-54758 Florida

Profile Details

NPI number 1982131678
LBN Legal business name Gray, Amanda Lynn
Credentials M.S., BCBA, IBA, LBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2017
Last updated Dec 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982131678 NPPES
Other 1-21-54758 BOARD CERTIFIED BEHAVIOR ANALYST (BCBA) WITH THE BACB
Other 0133002472 BOARD CERTIFIED BEHAVIOR ANALYST (BCBA) WITH THE BACB
MEDICAID 020898300 BOARD CERTIFIED BEHAVIOR ANALYST (BCBA) WITH THE BACB

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