Individual
MRS. AMANDA BOWERS GRIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC LMFT
Contact information
Practice address
644 INDEPENDENCE PKWY STE 200, CHESAPEAKE, VA 23320-5212
(757) 547-1811
(757) 547-1811
Mailing address
644 INDEPENDENCE PKWY STE 200, CHESAPEAKE, VA 23320-5212
(757) 547-1811
(757) 547-1811
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002570
VA
106H00000X
Marriage & Family Therapist
0717000300
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005415144
—
VA
01
—
236537
ANTHEM
—
01
—
323829
TRICARE
—
Enumeration date
09/27/2006
Last updated
04/17/2024
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