Individual
AMANDA GARBACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QBHP
Contact information
Practice address
114 E CRANDALL AVE STE B, HARRISON, AR 72601-3628
(870) 741-8484
(870) 741-4088
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
(471) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
0000
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AR
Enumeration date
04/26/2021
Last updated
04/26/2021
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