MEDICARE: AMANDA DORTCH M.S.

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
1	101Y00000X	Counselor		TX

General Provider Information

NPI Number	:	1164145983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DORTCH M.S.

Provider Business Mailing Address
First Line	:	8140 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4350
Country	:	US
Telephone Number	:	469-247-0402
Fax Number	:

Provider Business Practice Location Address
First Line	:	8140 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4350
Country	:	US
Telephone Number	:	469-247-0402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	05/16/2025

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Directions to “ AMANDA DORTCH M.S.” Practice Location

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