Individual
MISS AMANDA MARIE OSWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1062 FULTON ST APT 2, SAN FRANCISCO, CA 94117-1627
(321) 698-9915
Mailing address
1062 FULTON ST, APT 2, SAN FRANCISCO, CA 94117-1627
(321) 698-9915
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
O243-013-81-799-0
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O243-013-81-799-0
DRIVERS LICENCE
FL
Enumeration date
05/30/2008
Last updated
05/30/2008
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