Individual
AMANDA SUE DEWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, BSL
Contact information
Practice address
500 OFFICE CENTER DR STE 100, FORT WASHINGTON, PA 19034-3234
(727) 420-7002
Mailing address
500 OFFICE CENTER DR STE 100, FORT WASHINGTON, PA 19034-3234
(727) 420-7002
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BH007104
PA
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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