| NPI | 1114370707 |
|---|---|
| Former Name | AMANDA NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 5332) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 24036) |
| 104100000X Social Worker (Licence: ND 5332) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2021-06-02 |