| Doctor Name: | MS. AMANDA JANE WADLEY |
| NPI Number: | 1083893457 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., LPC |
| License Number: | LPC005012 |
| Business Practice Address: | 102 S Zetterower Ave Statesboro, GA - 304584816 |
| Business Phone Number: | 9127646731 |
| Business Fax Number: | 9127646789 |
| Mailing Address: | 201 Magnolia Pl, STATESBORO |
| State: | GA |
| Postal Code: | 304614248 |
| Phone Number: | 9125877201 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2007 |
| NPI Last Update Date: | 11/29/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC005012 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |