Provider Demographics
NPI:1871285031
Name:HEGEL, AMANDA (LMMT/MLD-C/CLT)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:
Last Name:HEGEL
Suffix:
Gender:F
Credentials:LMMT/MLD-C/CLT
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:ALCAZAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMMT/MLD-C/CLT
Mailing Address - Street 1:840 E GREEN ST UNIT 416
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-5434
Mailing Address - Country:US
Mailing Address - Phone:818-693-0774
Mailing Address - Fax:
Practice Address - Street 1:333 S ARROYO PKWY FL 3
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2581
Practice Address - Country:US
Practice Address - Phone:818-693-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist