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General NPI Number Information
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NPI Number | 1467870501
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Entity Type | Individual
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Provider Name | AMANDA KAY DUTTON LPC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2014
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 9010 PINE TREE CIR
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City | GAINESVILLE
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State | GA
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Zip | 30506-4039
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Country | US
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Telephone | 678-541-8917
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Fax |
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Provider Business Mailing Address
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Address Line | 5021 FLORENCE ST
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City | OAKWOOD
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State | GA
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Zip | 30566-2646
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Country | US
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Telephone | 678-541-8917
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC0016126
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC009255
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License Number State | GA
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