Individual
DR. AMANDA DEDIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LPC, NCC, BC-TM
Contact information
Practice address
123 W 1ST ST STE 208A, CASPER, WY 82601-2480
(307) 234-7419
Mailing address
123 W 1ST ST STE 208A, CASPER, WY 82601-2480
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
0018339
CO
101YP2500X
Professional Counselor
Primary
2047
WY
Other
Enumeration date
03/05/2014
Last updated
06/28/2022
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