IndividualActive
Amanda Icenogle
NPI 1174198808 · Behavior Analyst · Dothan, AL
Provider details
- NPI number
- 1174198808
- Entity type
- Individual
- Primary specialty
- Behavior AnalystBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 103K00000X
Practice location
2543 Ross Clark Cir
Dothan, AL 36301-4925
Phone: (334) 699-4007
Fax: (334) 699-4014
Mailing address
60 County Road 755
Enterprise, AL 36330-1553
Registry dates
- Enumerated
- 2021-05-25
- Last updated
- 2021-05-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.