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NPI 1659949063

NPI 1659949063 : AMANDA LUNT : GEORGETOWN, TX

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General NPI Number Information
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    NPI Number           |    1659949063
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA LUNT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/12/2021
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    Last Update Date     |    06/12/2021
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Provider Practice Location Address
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    Address Line         |    401 W 6TH ST 
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    City                 |    GEORGETOWN
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    State                |    TX
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    Zip                  |    78626-7701
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    Country              |    US
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    Telephone            |    512-713-9886
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    502 SUNSET RIDGE DR 
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    City                 |    KILLEEN
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    State                |    TX
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    Zip                  |    76549-5519
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    Country              |    US
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    Telephone            |    
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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