Doctor Name: | AMANDA NEKOUD |
NPI Number: | 1003231762 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | IMF78812 |
Business Practice Address: | 1529 E Palmdale Blvd Ste 210 Palmdale, CA - 935502029 |
Business Phone Number: | 6612729996 |
Business Fax Number: | |
Mailing Address: | 1529 E Palmdale Blvd Ste 210, PALMDALE |
State: | CA |
Postal Code: | 935502029 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 03/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | IMF78812 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |