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NPI Code Detail

MEDICARE: AMANDA RAYE PALMER

MEDICARE: AMANDA RAYE PALMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401016693MI
2101YP2500XProfessional Counselor6401018845MI

General Provider Information

NPI Number : 1073167235
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RAYE PALMER
Provider Business Mailing Address
First Line : 581 ALLEN ST
Second Line :
City : FERNDALE
State : MI
Zip : 48220-2444
Country : US
Telephone Number : 810-407-4882
Fax Number :
Provider Business Practice Location Address
First Line : 5505 CORPORATE DR
Second Line :
City : TROY
State : MI
Zip : 48098-2614
Country : US
Telephone Number : 313-224-0715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2019
Last Update Date : 12/03/2020

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Directions to “ AMANDA RAYE PALMER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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