Individual
MS. AMANDA M COSIO-BOGNUDA-CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4513
(805) 781-4997
Mailing address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4513
(805) 781-4997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
82927
CA
1041C0700X
Clinical Social Worker
ASW 64535
CA
Other
Enumeration date
08/31/2010
Last updated
09/21/2018
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