Wallace, Amanda

Wallace, Amanda is an sole proprietor health care provider with primary practice located at 1907 Kristy Ct , Longmont CO 80504-7387. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wallace, Amanda can be contacted via phone (303) 507-5210.

Contact Information

Primary practice address
1907 Kristy Ct Longmont CO 80504-7387
Phone: (303) 507-5210
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3502 Colorado

Profile Details

NPI number 1366635245
LBN Legal business name Wallace, Amanda
Credentials MA, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2007
Last updated Aug 23rd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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