| Doctor Name: | MS. AMANDA LEIGH VITALI |
| NPI Number: | 1245553734 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | PC004603 |
| Business Practice Address: | 403 Spinner Rd Honesdale, PA - 184317634 |
| Business Phone Number: | 5702539323 |
| Business Fax Number: | |
| Mailing Address: | Po Box 362, LAKE ARIEL |
| State: | PA |
| Postal Code: | 184360362 |
| Phone Number: | 5708788561 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2010 |
| NPI Last Update Date: | 03/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC004603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |