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1265147623
AMANDA WILLIS-MARTIN
BEMIDJI, MN
NPI
1265147623
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 306564)
Enumeration Date
2023-01-19
Last Update Date
2023-06-20
Business Address
AMANDA WILLIS-MARTIN LADC
1705 ANNE ST NW
BEMIDJI, MN 56601-6151
Phone number: 218-333-2006
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Mailing Address
AMANDA WILLIS-MARTIN LADC
PO BOX 5074
SIOUX FALLS, SD 57117-5074
Phone number:
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