Individual
AMANDA BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17321 TELEGRAPH RD, DETROIT, MI 48219-3132
(313) 531-2500
Mailing address
4440 HUNT CLUB DR APT 2A, YPSILANTI, MI 48197-9225
(313) 658-3502
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6851109695
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/24/2018
Last updated
07/27/2021
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