Amanda Icenogle

NPI #1174198808 in Dothan, Alabama

Provider Information

NPI Number: 1174198808
Entity Type: Individual
Name: Amanda Icenogle
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Enumeration Date: May 25, 2021
Last Updated: May 25, 2021

Practice Location

Address: 2543 ROSS CLARK CIR
City: Dothan
State: Alabama
ZIP Code: 36301-4925
Phone: (334) 699-4007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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