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1023751393
AMANDA SELF
SACRAMENTO, CA
NPI
1023751393
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 13199)
Enumeration Date
2022-04-15
Last Update Date
2022-06-23
Business Address
AMANDA SELF SUDRC 13199
310 HARRIS AVE STE A
SACRAMENTO, CA 95838-3249
Phone number: 916-649-6793
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Mailing Address
AMANDA SELF SUDRC 13199
22 MARILYN CIR
SACRAMENTO, CA 95838-2017
Phone number:
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