Individual
AMANDA MAE HENNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1 MARCELA DR, WILLITS, CA 95490-5769
(707) 621-2720
Mailing address
8251 W SIDE POTTER VALLEY RD, POTTER VALLEY, CA 95469-8700
(707) 621-2720
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
27200
CA
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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