Individual
AMANDA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2620 PERKINS CREEK DR, PADUCAH, KY 42001-7494
(270) 444-8465
Mailing address
828 STATE ROUTE 1763, WINGO, KY 42088-9356
(270) 705-9003
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
255727
KY
Other
Enumeration date
08/04/2023
Last updated
10/16/2023
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