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1427301191
AMANDA GRACE MCKNELLY
SIOUX FALLS, SD
NPI
1427301191
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: SD 11091490)
Enumeration Date
2012-10-18
Last Update Date
2012-10-18
Business Address
-- AMANDA GRACE MCKNELLY CCDCIII
2412 S CLIFF AVE STE 100
SIOUX FALLS, SD 57105-4031
Phone number: 605-322-4079
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Mailing Address
-- AMANDA GRACE MCKNELLY CCDCIII
720 S PRAIRIE AVE
TEA, SD 57064-3216
Phone number: 605-322-4079
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