Individual
AMANDA KNICKERBOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
155 MICAN RD, WAYMART, PA 18472-3034
(570) 647-7820
Mailing address
155 MICAN RD, WAYMART, PA 18472-3034
(570) 647-7820
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC014704
PA
Other
Enumeration date
08/06/2022
Last updated
08/06/2022
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