| NPI | 1407223381 |
|---|---|
| Former Name | AMANDA K STARY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3503) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 4824) |
| 101YM0800X Counselor, Mental Health (Licence: NE 10637) | |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2022-07-21 |