Individual
AMANDA ROSE DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(541) 921-4712
Mailing address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(541) 921-4712
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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