Doctor Name: | AMANDA VANDERHEYDEN |
NPI Number: | 1700217312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | MA52401 |
Business Practice Address: | 206 Sw Atlanta Ave Stuart, FL - 349942034 |
Business Phone Number: | 8638127922 |
Business Fax Number: | |
Mailing Address: | 3911 Nw Cinnamon Tree Cir, 34957 JENSEN BEACH |
State: | FL |
Postal Code: | 349573640 |
Phone Number: | 8638127922 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2013 |
NPI Last Update Date: | 12/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA52401 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |