Doctor Name: | MRS. AMANDA JOHNSON-LATHAM |
NPI Number: | 1033346150 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW-CP |
License Number: | SC7401 |
Business Practice Address: | 775 Spartan Blvd Suite 101b Spartanburg, SC - 293011370 |
Business Phone Number: | 8645879798 |
Business Fax Number: | |
Mailing Address: | 9 Carderock Ct, SIMPSONVILLE |
State: | SC |
Postal Code: | 296807901 |
Phone Number: | 8642498899 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2009 |
NPI Last Update Date: | 06/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SC7401 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |