| NPI | 1457810871 | 
|---|---|
| Former Name | AMANDA MARY BODE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016482) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361999795) | 
| Enumeration Date | 2019-03-15 | 
| Last Update Date | 2025-03-26 |