Individual
MRS. AMANDA PORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1830 DESTINY LN, SUITE 112, BOWLING GREEN, KY 42104-1087
(270) 999-1152
(270) 393-9001
Mailing address
1830 DESTINY LN, SUITE 112, BOWLING GREEN, KY 42104-1087
(270) 999-1152
(270) 393-9001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4005
KY
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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