Individual
MRS. AMANDA BETH BOEING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
811 18TH ST, CARLYLE, IL 62231-1317
(618) 304-6822
(618) 526-8831
Mailing address
811 18TH ST, CARLYLE, IL 62231-1317
(618) 304-6822
(618) 526-8831
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150012365
IL
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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