| NPI | 1144748930 |
|---|---|
| Former Name | AMANDA CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2015040579) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2015040579) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2025-02-25 |