Individual
MS. AMANDA AGNES ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(608) 789-4894
(608) 785-6315
Mailing address
1914 30TH ST S, LA CROSSE, WI 54601-6908
(608) 799-5963
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1704-127
WI
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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