Individual
AMANDA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
11022 S 51ST ST STE 200, PHOENIX, AZ 85044-4307
(602) 363-0629
(480) 247-4179
Mailing address
16620 N 40TH ST STE G1, PHOENIX, AZ 85032-3351
(602) 363-0629
(480) 247-4179
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC20189
AZ
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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