Individual
MS. AMANDA LEEH BLACKHORSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
HWY 163 BLDG KA-2010, KAYENTA, AZ 86033-0368
(928) 697-4000
(928) 697-4189
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
(928) 697-4000
(928) 697-4189
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-13279
AZ
Other
Enumeration date
06/10/2013
Last updated
06/10/2013
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