Individual
MISS AMANDA HENRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
604 PEARL ST, MONTEREY, CA 93940-3070
(831) 647-3000
Mailing address
977 PORTOLA DR, DEL REY OAKS, CA 93940-5539
(928) 587-1291
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M0000X
BEHAVIORAL HEALTH AIDE MHS
CA
Enumeration date
10/17/2014
Last updated
10/23/2014
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