Individual
AMANDA N ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
904 ALTENAU STREET, COSMOPOLIS, WA 98537
(360) 612-0495
Mailing address
PO BOX 558, COSMOPOLIS, WA 98537-0558
(360) 612-0495
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/24/2010
Last updated
11/23/2011
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