| NPI | 1346642212 |
|---|---|
| Former Name | AMANDA SCHRADERMEIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55230) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 1710296975) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2019-10-28 |