Individual
AMANDA BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ED
Contact information
Practice address
1251 N EDDY ST, SUITE 200, SOUTH BEND, IN 46617-1479
(574) 406-1808
Mailing address
PO BOX 694, SOUTH BEND, IN 46624-0694
(574) 406-1808
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10136107
IN
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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