Individual
MS. PATTIE BURNS AMUNDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6315 TOBACCOVILLE RD., TOBACCOVILLE, NC 27050
(336) 924-8818
Mailing address
169 FORESTVIEW DR., WINSTON SALEM, NC 27104
(336) 659-8244
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
LPC 2853
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-2853
LICENSED PROF COUNSELOR
NC
Enumeration date
03/16/2007
Last updated
07/09/2007
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