Individual
AMANDA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
700 GW LN, WAYNESVILLE, MO 65583-2325
(573) 814-6266
Mailing address
700 GW LN, WAYNESVILLE, MO 65583-2325
(573) 814-6266
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2015021457
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015021457
LICENSE
MO
Enumeration date
07/10/2015
Last updated
07/10/2015
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