| NPI | 1356432579 | 
|---|---|
| Former Name | AMANDA COREEN BOWERS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002570)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000300)  | 
| Enumeration Date | 2006-09-27 | 
| Last Update Date | 2024-04-17 |