Individual
AMANDA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 N DIXIE HWY # A, ELIZABETHTOWN, KY 42701-2621
(270) 765-2605
Mailing address
4201 BRIDGEWATER CV, APARTMENT 11, LOUISVILLE, KY 40207-5315
(812) 459-9934
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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