Individual
AMANDA MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3031 TISCH WAY, SUITE 306, SAN JOSE, CA 95128-2541
(408) 350-1313
Mailing address
3031 TISCH WAY, SUITE 306, SAN JOSE, CA 95128
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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