| NPI | 1013017862 |
|---|---|
| Former Name | AMANDA WILLIAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 339) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 622) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-09-14 |