Individual
MRS. AMANDA M. MULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11103 PARK RD, LOUISVILLE, KY 40223-2424
(502) 753-5521
Mailing address
11103 PARK RD, LOUISVILLE, KY 40223-2424
(502) 753-5521
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254408
KY
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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