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General NPI Number Information
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NPI Number | 1073493979
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Entity Type | Individual
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Provider Name | AMANDA MARIE HART LLMSW
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1350 S MILFORD RD
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City | HIGHLAND
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State | MI
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Zip | 48357-4858
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Country | US
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Telephone | 517-551-0084
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Fax | 517-515-7441
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Provider Business Mailing Address
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Address Line | 9801 MARSH RD
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City | FOWLERVILLE
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State | MI
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Zip | 48836-9311
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Country | US
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Telephone | 517-551-0084
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Fax | 517-515-7441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 685119490
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License Number State | MI
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