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Individual

AMANDA MARIE JARAMILLO AYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
803 3RD AVE, COUNCIL BLUFFS, IA 51501-4101
(712) 352-0917
Mailing address
2620 1ST AVE S APT 212, ALTOONA, IA 50009-2461
(712) 621-5985

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
086196
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1210140
IA
Enumeration date
09/26/2018
Last updated
09/26/2018
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