# MRS. AMANDA RUSSELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699730952
- **Gender:** F
- **Credential:** CSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 5922570-3502 | UT | — |
| 1041C0700X | Clinical Social Worker | 5922570-3501 | UT | Yes |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 02/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 788007788049 | — | UT |