Individual
AMANDA AMANDA ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW; LSCSW
Contact information
Practice address
501 N SUNSET LN, RAYMORE, MO 64083-9402
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2017037386
MO
1041C0700X
Clinical Social Worker
05533
MO
1041C0700X
Clinical Social Worker
Primary
2021005786
MO
Other
Enumeration date
11/17/2017
Last updated
04/24/2023
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