Organization
AMANDA WAIDELICH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA M WAIDELICH M.A, NCC, LPC, LLMFT (OWNER)
(517) 488-5667
Entity
Organization
Contact information
Practice address
219 N QUEEN ST, NASHVILLE, MI 49073-9323
(517) 488-5667
(888) 720-8803
Mailing address
219 N QUEEN ST, NASHVILLE, MI 49073-9323
(517) 488-5667
(888) 720-8803
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6401012853
MI
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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