Individual
AMANDA DIMARTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3543 S LONE PINE AVE, SPRINGFIELD, MO 65804-4854
(417) 379-4781
Mailing address
3543 S LONE PINE AVE, SPRINGFIELD, MO 65804-4854
(417) 379-4781
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010042210
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002283881
CHILDREN'S TREATMENT SERVICES
MO
Enumeration date
04/28/2011
Last updated
01/05/2015
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