| NPI | 1013147958 |
|---|---|
| Former Name | AMANDA MARIE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2015-03-01 |