Individual
AMY SIDDENS LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1 N BARKER AVE, EVANSVILLE, IN 47712-5601
(812) 423-4418
(812) 422-7558
Mailing address
415 MULBERRY ST, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006238
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000711602
ANTHEM
IN
01
—
12227764
CAQH
IN
Enumeration date
03/15/2010
Last updated
04/29/2013
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