Individual
AMANDA KATHLEEN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2731 NUGGET AVE, LAKE ISABELLA, CA 93240-9456
(760) 379-3412
Mailing address
2731 NUGGET AVE, LAKE ISABELLA, CA 93240-9456
(760) 379-3412
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
128511
CA
Other
Enumeration date
04/01/2020
Last updated
10/13/2021
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