| NPI | 1811393747 |
|---|---|
| Former Name | AMANDA PATTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 7132) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SD LPC7324) |
| 101YP2500X Counselor, Professional (Licence: MD LC4376) | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2019-12-09 |