Individual
AMANDA EMILY MITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
130 E POPLAR ST STE CANDD, FAYETTEVILLE, AR 72703-2532
(479) 435-6047
(479) 755-3595
Mailing address
130 E POPLAR ST STE C&D, FAYETTEVILLE, AR 72703-2532
(479) 435-6047
(479) 755-3595
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
AR
104100000X
Social Worker
2506-M
AR
1041C0700X
Clinical Social Worker
Primary
3666-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207147719
—
AR
Enumeration date
07/29/2010
Last updated
11/07/2022
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