| NPI | 1285084152 |
|---|---|
| Former Name | AMANDA SHIELDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4934) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 206) |
| 104100000X Social Worker (Licence: KS 9957) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2024-11-14 |