Healthcare Provider Details
I. General information
NPI: 1346150885
Provider Name (Legal Business Name): AMANDA CLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2702 B 1/2 RD
GRAND JUNCTION CO
81503-2815
US
IV. Provider business mailing address
2934 PATTERSON RD
GRAND JUNCTION CO
81504-3004
US
V. Phone/Fax
- Phone: 970-504-0898
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: