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General NPI Number Information
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NPI Number | 1881489003
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Entity Type | Individual
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Provider Name | AMANDA YATS
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Gender | Female
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 40600 ANN ARBOR RD E STE 175
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City | PLYMOUTH
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State | MI
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Zip | 48170-4664
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Country | US
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Telephone | 734-674-7579
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 TATES CREEK RD APT 1179
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City | LEXINGTON
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State | KY
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Zip | 40517-3080
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801120035
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License Number State | MI
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