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Individual

AMANDA DUFOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSW, LCADC

Contact information

Practice address
2220 EXECUTIVE DR STE 102, LEXINGTON, KY 40505-4871
(859) 309-8737
Mailing address
PO BOX 2141, LEXINGTON, KY 40588-2141

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
278317
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
104100000X
Social Worker
257182
KY

Other

Enumeration date
07/29/2020
Last updated
05/25/2023
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