Individual
MISS AMANDA BLAIR FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCAS, NBCC
Contact information
Practice address
503 ROCKINGHAM RD, ROCKINGHAM, NC 28379-3615
(910) 410-4922
Mailing address
1016 LEGENDS DR, SOUTHERN PINES, NC 28387-3448
(910) 736-1261
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8888
NC
Other
Enumeration date
01/29/2013
Last updated
08/18/2016
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