Individual
MRS. AMANDA KATHERINE VAN EMBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
725 HIGHLAND AVE, WINSTON SALEM, NC 27101-4206
(336) 607-8523
Mailing address
720 OLD GASTON PL, WINSTON SALEM, NC 27103-3878
(703) 864-4444
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3620
NC
Other
Enumeration date
08/23/2006
Last updated
10/02/2008
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