Individual
MS. AMANDA TERRYCE GIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
999 HOME PLZ STE 301, WATERLOO, IA 50701-4822
(319) 299-2864
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 235-5390
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
086882
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074435
—
IA
Enumeration date
07/19/2017
Last updated
01/09/2024
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