Individual
AMANDA MANDRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A., BHRS, BHCM II
Contact information
Practice address
11005 N BLACKWELDER AVE, OKLAHOMA CITY, OK 73120-7917
(405) 740-0200
(405) 740-0200
Mailing address
11005 N BLACKWELDER AVE, OKLAHOMA CITY, OK 73120-7917
(405) 740-0200
(405) 740-0200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200482330A
—
OK
Enumeration date
04/12/2013
Last updated
06/22/2016
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