Individual
AMANDA MANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 W B ST STE D, SPRINGFIELD, OR 97477-4575
(541) 762-1971
Mailing address
745 25TH ST, SPRINGFIELD, OR 97477-4421
(541) 762-1971
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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