Individual
AMANDA FONDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, M-DT
Contact information
Practice address
12166 OLD BIG BEND RD STE 102, KIRKWOOD, MO 63122-6836
(314) 717-0190
(314) 754-7275
Mailing address
6915 HILLSLAND AVE, SAINT LOUIS, MO 63109-1947
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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