Basic Information
Provider Information
NPI: 1164579769
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUYLER
FirstName: AMANDA
MiddleName: RUDY
NamePrefix: MS.
NameSuffix:  
Credential: M.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 124 PLEASANT ST
Address2:  
City: LITTLETON
State: NH
PostalCode: 035614906
CountryCode: US
TelephoneNumber: 5083803007
FaxNumber:  
Practice Location
Address1: 29 MAPLE ST
Address2:  
City: LITTLETON
State: NH
PostalCode: 035614729
CountryCode: US
TelephoneNumber: 6034445358
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/04/2007
LastUpdateDate: 12/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/28/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X851NHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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