Doctor Name: | AMANDA JANE HEBARD |
NPI Number: | 1306211628 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCA |
License Number: | A11828 |
Business Practice Address: | 502 Mcknight Dr Ste 200 Knightdale, NC - 275457050 |
Business Phone Number: | 9198447755 |
Business Fax Number: | 8004805850 |
Mailing Address: | 502 Mcknight Dr Ste 200, KNIGHTDALE |
State: | NC |
Postal Code: | 275457050 |
Phone Number: | 9198447755 |
Fax Number: | 8004805850 |
NPI Enumeration Date: | 12/11/2015 |
NPI Last Update Date: | 12/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | A11828 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |