Individual
MRS. AMANDA GAIL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1450 E 10TH ST, ROLLA, MO 65401-3648
(888) 403-1071
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2013033662
MO
Other
Enumeration date
10/02/2013
Last updated
09/27/2019
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