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Individual

AMANDA MALCOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC-INTERN

Contact information

Practice address
1601 E LAMAR BLVD, 214, ARLINGTON, TX 76011-4510
(817) 522-1095
(817) 460-0286
Mailing address
PO BOX 10117, RIVER OAKS, TX 76114-0117
(817) 624-1222
(817) 624-1213

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
68512
TX

Other

Enumeration date
04/11/2012
Last updated
04/11/2012
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