Individual
AMANDA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
200 COMMODORE ST, PRATT, KS 67124-2903
(620) 450-1163
Mailing address
200 COMMODORE ST, PRATT, KS 67124-2903
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC3578
KS
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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