| Doctor Name: | MRS. AMANDA JAMESON |
| NPI Number: | 1023400496 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, CSC |
| License Number: | 70069 |
| Business Practice Address: | 3840 Gilmer Rd Longview, TX - 756041173 |
| Business Phone Number: | 9039187797 |
| Business Fax Number: | 9032955858 |
| Mailing Address: | 3840 Gilmer Rd, LONGVIEW |
| State: | TX |
| Postal Code: | 756041173 |
| Phone Number: | 9039187797 |
| Fax Number: | 9032955858 |
| NPI Enumeration Date: | 02/23/2015 |
| NPI Last Update Date: | 03/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 70069 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |