| NPI | 1780012062 |
|---|---|
| Former Name | AMANDA BOLDING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 2540) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1076) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |