Dorman, Amanda Keri

Dorman, Amanda Keri is an individual health care provider with primary practice located at 17390 Dugdale Dr , South Bend IN 46635-1512. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Assistant Behavior Analyst, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Dorman, Amanda Keri can be contacted via phone (574) 400-2169.

Contact Information

Primary practice address
17390 Dugdale Dr South Bend IN 46635-1512
Phone: (574) 400-2169
Fax: (765) 454-9759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1558725267
LBN Legal business name Dorman, Amanda Keri
Credentials MA, BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 8th, 2016
Last updated Apr 23rd, 2018 - about 6 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 1558725267 NPPES
Other 1-18-30099 BCBA CERTIFICATE
Other 0-16-7064 BCBA CERTIFICATE

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