Individual
AMANDA KARLY WISHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
888 WILLOW ST, RENO, NV 89502-1304
(775) 384-1129
Mailing address
774 HUNTER LAKE DR, RENO, NV 89509-1216
(775) 340-9203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
06794-LCI
NV
104100000X
Social Worker
7961-S
NV
1041C0700X
Clinical Social Worker
Primary
9776-C
NV
Other
Enumeration date
01/08/2020
Last updated
03/16/2023
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