Individual
AMANDA KIRTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
107 W PARK DR, HATTIESBURG, MS 39402-1363
(601) 606-1954
Mailing address
107 W PARK DR, HATTIESBURG, MS 39402-1363
(601) 606-1954
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1949
MS
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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