Individual
AMANDA BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
2420 LINWOOD DR STE 1, PARAGOULD, AR 72450-6122
(870) 236-5880
(870) 236-5757
Mailing address
2420 LINWOOD DR STE 1, PARAGOULD, AR 72450-6122
(870) 335-5880
(870) 236-5757
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1123
—
AR
Enumeration date
09/26/2008
Last updated
01/12/2011
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