Blazkiewicz, Amanda Michelle

Blazkiewicz, Amanda Michelle is an individual health care provider with primary practice located at 1200 W Tabor Rd , Philadelphia PA 19141-3019. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Blazkiewicz, Amanda Michelle can be contacted via phone (215) 456-9850.

Contact Information

Primary practice address
1200 W Tabor Rd Philadelphia PA 19141-3019
Phone: (215) 456-9850
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1366964447
LBN Legal business name Blazkiewicz, Amanda Michelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2017
Last updated Jul 13th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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