Provider Demographics
NPI:1952280877
Name:MCFADDEN, AMANDA D (LMT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:D
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:D
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BE BALANCED SPA
Mailing Address - Street 1:205 W ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1955
Mailing Address - Country:US
Mailing Address - Phone:251-880-9367
Mailing Address - Fax:
Practice Address - Street 1:205 W ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1955
Practice Address - Country:US
Practice Address - Phone:251-880-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4545225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist