Individual
AMANDA LYNNE CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1500 HUGHES WAY # 100, LONG BEACH, CA 90810-1870
(213) 252-5800
Mailing address
2121 W TEMPLE ST, LOS ANGELES, CA 90026-4915
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2022
Last updated
06/13/2022
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