| NPI | 1265823504 |
|---|---|
| Former Name | AMANDA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095730) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2025-09-10 |