Individual provider · Type 1 NPI

Amanda Marie Johnston-Porter, CRPA-P

Peer Specialist · Waterloo, NY

NPI number 1164071882 Active

Practice location

31 Thurber Dr
Waterloo, NY 13165-1665

Call (315) 539-1985 Map

Fax (315) 539-4393

Mailing address

18 Fayette St
Waterloo, NY 13165-1708

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1164071882

Amanda Marie Johnston-Porter, CRPA-P's National Provider Identifier is 1164071882, issued on Sep 5, 2019. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Waterloo, NY. The record was last updated on Sep 5, 2019.