Individual
MRS. AMANDA M. LONGIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAPC, MAHR, LADC
Contact information
Practice address
403 4TH ST NW, SUITE 300, BEMIDJI, MN 56601-3142
(218) 444-5155
(218) 333-3291
Mailing address
PO BOX 3004, BEMIDJI, MN 56619-3004
(218) 444-5155
(218) 333-3921
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304052
MN
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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