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Individual

MS. AMANDA L WALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
3686 US HIGHWAY 331 SOUTH, DEFUNIAK SPRINGS, FL 32435-8463
(850) 892-8035
(850) 892-8074
Mailing address
3686 US HIGHWAY 331 SOUTH, DEFUNIAK SPRINGS, FL 32435-8463
(850) 892-8035
(850) 892-8074

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH 11323
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MH 11323
LICENSED MENTAL HEALTH COUNSELOR
FL
Enumeration date
08/29/2012
Last updated
09/04/2012
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