Individual
AMANDA WEATHERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 W 1ST ST STE 200, RENO, NV 89503-5587
(775) 677-2216
Mailing address
365 EL PRADO AVE, LAS CRUCES, NM 88005-2906
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
235Z00000X
Speech-Language Pathologist
Primary
C-6221
NM
Other
Enumeration date
09/24/2012
Last updated
11/21/2017
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