Individual
AMANDA JOANN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2549 W SHAW AVE, FRESNO, CA 93711-3308
(559) 579-1744
Mailing address
2549 W SHAW AVE, FRESNO, CA 93711-3308
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/17/2025
Last updated
09/18/2025
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