Individual
AMANDA NUGENT DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LMFT
Contact information
Practice address
3780 ROSIN CT, SUITE 110, SACRAMENTO, CA 95834-1646
(916) 417-7374
Mailing address
3533 LAMBETH DR, RESCUE, CA 95672-9391
(310) 663-0752
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
67208
TX
106H00000X
Marriage & Family Therapist
Primary
46360
CA
Other
Enumeration date
05/01/2007
Last updated
03/14/2012
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