Individual
AMANDA STOREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
1505 15TH ST, SUITE C, LOS ALAMOS, NM 87544-3000
(505) 662-3264
Mailing address
2084 46TH ST, LOS ALAMOS, NM 87544-1719
(505) 310-5316
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0144921
NM
101YM0800X
Mental Health Counselor
Primary
0176431
NM
Other
Enumeration date
12/06/2011
Last updated
12/20/2016
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