Healthcare Provider Details

I. General information

NPI: 1063211746
Provider Name (Legal Business Name): AMANDA STEEN LMT, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20068 SUMMER PL
PIERRE SD
57501-6267
US

IV. Provider business mailing address

20068 SUMMER PL
PIERRE SD
57501-6267
US

V. Phone/Fax

Practice location:
  • Phone: 612-708-3173
  • Fax:
Mailing address:
  • Phone: 612-708-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT10688
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: