Individual
MS. AMANDA LEE WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, CASAC
Contact information
Practice address
636 NEW LOUDON RD, LATHAM, NY 12110-4002
(518) 783-5381
Mailing address
636 NEW LOUDON RD, LATHAM, NY 12110-4002
(518) 783-5381
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000645
NY
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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