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Individual

AMANDA FREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
1591 W CENTRE AVE STE 205, PORTAGE, MI 49024-6315
(269) 252-4004
Mailing address
2596 CHESTNUT RIDGE AVE, PORTAGE, MI 49024-7600
(419) 345-7404

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015735
MI
106H00000X
Marriage & Family Therapist
4101006707
MI

Other

Enumeration date
10/21/2016
Last updated
07/25/2022
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