Individual
AMANDA MICHELLE ROLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, ATR
Contact information
Practice address
1330 BEACON ST STE 317, BROOKLINE, MA 02446-3202
(508) 492-0174
Mailing address
1330 BEACON ST STE 317, BROOKLINE, MA 02446-3202
(508) 492-0174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11431
MA
221700000X
Art Therapist
19-099
MA
Other
Enumeration date
05/20/2020
Last updated
09/15/2023
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