Organization
A POSITIVE CHANGE
Active
Organization
A POSITIVE CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA ANNA BOLEY PSYD LMHC (PSYCHOTHERAPIST)
(253) 225-2275
Entity
Organization
Contact information
Practice address
5262 OLYMPIC DRIVE SUITE C, GIG HARBOR, WA 98335
(253) 225-2275
Mailing address
5262 OLYMPIC DRIVE SUITE C, GIG HARBOR, WA 98335
(253) 225-2275
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LH60429375
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LH60429375
LMHC LH60429375
WA
Enumeration date
04/09/2015
Last updated
04/09/2015
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