| Doctor Name: | DR. AMANDA CP[E;AMD |
| NPI Number: | 1417053570 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC,NCC, NCGC, K-12 |
| License Number: | 806 |
| Business Practice Address: | 1600 E Hollow Oak Rd Stigler, OK - 744629728 |
| Business Phone Number: | 9189678736 |
| Business Fax Number: | |
| Mailing Address: | 1600 E Hollow Oak Rd, STIGLER |
| State: | OK |
| Postal Code: | 744629728 |
| Phone Number: | 9189678736 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 806 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |