Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Icenogle

Individual provider Behavior Analyst · NPI 1174198808

Amanda Icenogle is an Undefined Non-Physician Type (Specify) in Dothan, Alabama. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
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Practice location Address checks out

2543 Ross Clark Cir
Dothan, AL 36301-4925
Phone: (334) 699-4007
Fax: (334) 699-4014
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 103K00000X

Record details

NPI number1174198808
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 25, 2021
Last updated in NPPESMay 25, 2021
Certification dateMay 21, 2021
Mailing address60 County Road 755, Enterprise, AL 36330-1553

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Dothan