Provider Demographics
NPI:1700679776
Name:CRAVEN, AMANDA NICOLE HARTMAN (EDUCATION SPECIALIST)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE HARTMAN
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:EDUCATION SPECIALIST
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:NICOLE
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13043 W 450 N
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-6140
Mailing Address - Country:US
Mailing Address - Phone:520-258-8869
Mailing Address - Fax:
Practice Address - Street 1:110 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47305-2839
Practice Address - Country:US
Practice Address - Phone:520-258-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10285624103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool