Individual
AMANDA JO HOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
32405 DIAGONAL RD, HERMISTON, OR 97838-7503
(541) 567-2593
(888) 977-2106
Mailing address
32405 DIAGONAL RD, HERMISTON, OR 97838-7503
(541) 567-2593
(888) 977-2106
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
150113
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669893673
—
OR
Enumeration date
03/15/2016
Last updated
03/15/2016
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