Individual
MS. AMANDA WALTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
233 S ALBANY ST, ITHACA, NY 14850-5403
(607) 256-2030
Mailing address
233 S ALBANY ST, ITHACA, NY 14850-5403
(607) 256-2030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
082080-1
NY
Other
Enumeration date
07/19/2018
Last updated
01/16/2019
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