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Individual

MISS AMANDA MARIE MASTRUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LMFT 93544

Contact information

Practice address
1360 N DUTTON AVE, STE. 100, SANTA ROSA, CA 95401-4687
(707) 529-0220
Mailing address
PO BOX 375, PETALUMA, CA 94953-0375
(707) 529-0220

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
93544
CA

Other

Enumeration date
09/28/2012
Last updated
07/28/2016
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