Individual
AMANDA JO SAMUDIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCCCA
Contact information
Practice address
3439 BUCKHORN DR, SUITE 160, LEXINGTON, KY 40515-1716
(859) 721-1636
Mailing address
3439 BUCKHORN DR, SUITE 160, LEXINGTON, KY 40515-1716
(859) 721-1636
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCCCA00216359
KY
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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