Individual
AMANDA BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ATR-BC, LPC
Contact information
Practice address
518 EASTON TPKE, LAKE ARIEL, PA 18436-4797
(570) 689-2644
Mailing address
PO BOX 942, HAMLIN, PA 18427-0942
(570) 689-2644
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC011094
PA
Other
Enumeration date
03/06/2019
Last updated
11/07/2019
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