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Individual

AMANDA C MASSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
615 N ALABAMA ST STE 320, INDIANAPOLIS, IN 46204-1432
(317) 634-6341
(317) 464-9575
Mailing address
615 N ALABAMA ST STE 320, INDIANAPOLIS, IN 46204-1432
(317) 634-6341
(317) 464-9575

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100264520
IN
Enumeration date
08/19/2008
Last updated
08/19/2008
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