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General NPI Number Information
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NPI Number | 1558848101
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Entity Type | Individual
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Provider Name | AMANDA WITMER LGSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 1664 WINCHESTER AVE STE B
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City | MARTINSBURG
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State | WV
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Zip | 25405-3881
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Country | US
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Telephone | 304-901-4347
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Fax | 888-596-2658
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Provider Business Mailing Address
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Address Line | 20 TATHER DR
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City | MARTINSBURG
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State | WV
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Zip | 25405-7203
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Country | US
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Telephone | 304-279-8802
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Fax | 888-596-2658
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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 | 14202
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License Number State | MD
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