Individual
AMANDA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-S
Contact information
Practice address
310 RUBBER RD, TAHLEQUAH, OK 74464-2522
(918) 817-1638
Mailing address
217 N WATER AVE, TAHLEQUAH, OK 74464-2825
(918) 817-1638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7223
OK
101Y00000X
Counselor
—
—
Other
Enumeration date
11/13/2014
Last updated
08/16/2024
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