Individual
AMANDA FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
2330 EASTGATE ST STE 105, WALLA WALLA, WA 99362-1559
(509) 973-5788
Mailing address
603 E MAPLE ST, WALLA WALLA, WA 99362-4203
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SC61201957
WA
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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