Doctor Name: | AMANDA NALL |
NPI Number: | 1013148360 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | NOO-353-270 |
Business Practice Address: | 502 Farrell Dr Covington, KY - 410113717 |
Business Phone Number: | 8595783200 |
Business Fax Number: | |
Mailing Address: | 502 Farrell Dr, COVINGTON |
State: | KY |
Postal Code: | 410113717 |
Phone Number: | 8595783200 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2009 |
NPI Last Update Date: | 08/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | NOO-353-270 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |