| NPI | 1629217682 |
|---|---|
| Former Name | AMANDA DIANE THOMASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3813) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 5428) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2018-03-17 |