Individual
MRS. AMY MARIE FITZWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
601 W NIFONG BLVD, SUITE 1B, BUILDING 1, COLUMBIA, MO 65203-6804
(573) 442-9669
Mailing address
1838 PINNACLE POINT DR, HOLTS SUMMIT, MO 65043-2065
(573) 424-2654
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011033841
MO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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