| NPI | 1689190613 |
|---|---|
| Former Name | AMANDA M DOUGLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2023-01-13 |