Amanda Bagwell
Individual provider Active NPI Counselor · Hernando, MS
NPI 1487937389 · NPPES record last updated Sep 27, 2011
Key facts
- NPI
- 1487937389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 2725 Highway 51 S
Hernando, MS 38632-2634 - Phone
- (662) 443-1808
- Fax
- (662) 449-1811
- NPI assigned
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
2725 Highway 51 S
Hernando, MS 38632-2634
Mailing address
PO Box 839
Corinth, MS 38835-0839
Phone (662) 286-9883
Other providers in Hernando, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.