Individual
AMANDA MARIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(617) 390-4585
(857) 203-6565
Mailing address
865 PLEASANT ST, BRIDGEWATER, MA 02324-2351
(781) 812-3393
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
224322
MA
1041C0700X
Clinical Social Worker
Primary
126170
MA
Other
Enumeration date
01/07/2021
Last updated
03/10/2023
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