Individual
DR. AMANDA L WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
6439 GARNERS FERRY RD BLDG 106, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD BLDG 106, COLUMBIA, SC 29209-1638
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043362B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
06/09/2020
Last updated
06/09/2020
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