Provider Demographics
NPI:1710348495
Name:CARDINAL, AMANDA JONES (MT-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JONES
Last Name:CARDINAL
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 VALLEY RD APT C65
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2264
Mailing Address - Country:US
Mailing Address - Phone:717-701-1209
Mailing Address - Fax:
Practice Address - Street 1:600 VALLEY RD APT C65
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2264
Practice Address - Country:US
Practice Address - Phone:717-701-1209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA12109225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist