Individual
AMANDA LIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
632 N SHIAWASSEE ST, OWOSSO, MI 48867
(989) 723-0330
(517) 676-5460
Mailing address
632 N SHIAWASSEE ST, OWOSSO, MI 48867-2232
(989) 723-0330
(517) 676-5460
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801098530
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P26570
MEDICARE PTAN
MI
05
—
1462371
—
MI
Enumeration date
10/26/2016
Last updated
10/26/2016
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