Individual
AMANDA LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
12247 STRATFORD DR, CLIVE, IA 50325-8147
(803) 636-7506
Mailing address
5604 ORCHARD DR, WEST DES MOINES, IA 50266-7692
(803) 636-7506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
124641
IA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/08/2018
Last updated
06/11/2024
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