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General NPI Number Information
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NPI Number | 1942952130
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Entity Type | Individual
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Provider Name | AMANDA HALLOWAY MA, AMFT
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Gender | Female
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 515 E 6TH ST FL 9
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City | LOS ANGELES
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State | CA
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Zip | 90021-1009
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Country | US
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Telephone | 213-395-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 1737 N BERENDO ST
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City | LOS ANGELES
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State | CA
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Zip | 90027-4151
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Country | US
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Telephone | 323-877-7513
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 130271
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License Number State | CA
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