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Individual

AMANDA CAROLINE GURGANUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
1703 COUNTRY CLUB RD STE 204, JACKSONVILLE, NC 28546-6006
(910) 347-3010
(910) 347-6137
Mailing address
117 38TH PL, MANHATTAN BEACH, CA 90266-3105
(310) 749-2684

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
200600453
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/26/2009
Last updated
05/14/2020
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