Individual
MS. AMANDA ANN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPS
Contact information
Practice address
766 ROBERTA ST, SALT LAKE CITY, UT 84111-3818
(801) 870-8877
Mailing address
766 ROBERTA ST, SALT LAKE CITY, UT 84111-3818
(801) 870-8877
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
084
UT
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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