Individual
AMANDA MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
415 NEPONSET AVE, DORCHESTER, MA 02122-3168
(857) 217-3700
(857) 217-3750
Mailing address
415 NEPONSET AVE, DORCHESTER, MA 02122-3168
(857) 217-3700
(857) 217-3750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
220963
MA
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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