Broughton, Amanda Jo

Broughton, Amanda Jo is an sole proprietor health care provider with primary practice located at 339 W Broadway Apt 3 , Eugene OR 97401-2883. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Broughton, Amanda Jo can be contacted via phone (949) 326-8894.

Contact Information

Primary practice address
339 W Broadway Apt 3 Eugene OR 97401-2883
Phone: (949) 326-8894
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Oregon
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1487037693
LBN Legal business name Broughton, Amanda Jo
Credentials BCBA, LBA-OR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2015
Last updated Jan 6th, 2017 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1487037693 NPPES
Oregon MEDICAID 500693767

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