| NPI | 1205698248 |
|---|---|
| Former Name | AMANDA LACKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CO LSW.0009925331) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002857) |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2026-01-27 |