Individual
MS. AMANDA LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14804 N CAVE CREEK RD STE 104, PHOENIX, AZ 85032-4945
(501) 613-8117
Mailing address
14804 N CAVE CREEK RD STE 104, PHOENIX, AZ 85032-4945
(501) 613-8117
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CLSG12192
AZ
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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