Individual
AMANDA JOY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(310) 668-3096
(310) 223-0910
Mailing address
75 HOCKANUM BLVD, UNIT 735, VERNON, CT 06066-4056
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003624
CT
Other
Enumeration date
09/13/2012
Last updated
01/11/2017
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