Individual
AMANDA JAYNE PINKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7203
Mailing address
1209 ILLINI DR, O FALLON, IL 62269-3548
(618) 580-4769
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2008033011
MO
1041C0700X
Clinical Social Worker
Primary
2008033011
MO
Other
Enumeration date
12/29/2008
Last updated
03/22/2023
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