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General NPI Number Information
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NPI Number | 1114535127
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Entity Type | Individual
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Provider Name | AMANDA LEWIS-YARBROUGH PHD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 141 MARKET PL
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City | MONTGOMERY
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State | AL
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Zip | 36117-4900
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Country | US
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Telephone | 334-398-8516
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Fax | 888-800-3749
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Provider Business Mailing Address
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Address Line | 141 MARKET PL
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City | MONTGOMERY
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State | AL
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Zip | 36117-4900
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Country | US
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Telephone | 334-398-8516
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Fax | 888-800-3749
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2256
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License Number State | AL
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