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General NPI Number Information
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NPI Number | 1568286524
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Entity Type | Organization
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Legal Business Name | AMANDA WILLETT, LLC
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 2727 BRYANT ST STE 610
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City | DENVER
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State | CO
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Zip | 80211-4153
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Country | US
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Telephone | 708-606-3994
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Fax |
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Provider Business Mailing Address
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Address Line | 3355 DENARGO ST UNIT 1-320
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City | DENVER
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State | CO
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Zip | 80216-5361
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Country | US
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Telephone | 708-606-3994
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | AMANDA WILLETT
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Credential | LCSW, MPH
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Telephone | 708-606-3994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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