Individual
AMANDA FREDERICK STEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
517 W GRACE ST, RICHMOND, VA 23220-4911
(804) 783-2505
Mailing address
110 W LABURNUM AVE, RICHMOND, VA 23222-1920
(804) 475-1457
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904014663
VA
Other
Enumeration date
12/20/2022
Last updated
12/20/2022
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