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Individual

MRS. AMANDA MARY ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
10201 W LINCOLN AVE STE 308, WEST ALLIS, WI 53227-2136
(414) 329-7000
Mailing address
S98W12878 LOOMIS RD, MUSKEGO, WI 53150-4907
(414) 403-5372

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6729-125
WI

Other

Enumeration date
12/28/2017
Last updated
12/28/2017
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