Individual
AMANDA WILLIS-MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-2006
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306564
MN
Other
Enumeration date
01/19/2023
Last updated
09/11/2025
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