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NPI Code Detail

MEDICARE: AMANDA NICOLE HUA MA, EMDR, NCC

MEDICARE:   AMANDA NICOLE HUA  MA, EMDR, NCC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1417519919
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA NICOLE HUA MA, EMDR, NCC
Provider Business Mailing Address
First Line : 3225 S WADSWORTH BLVD UNIT T
Second Line :
City : LAKEWOOD
State : CO
Zip : 80227-5009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3225 S WADSWORTH BLVD UNIT T
Second Line :
City : LAKEWOOD
State : CO
Zip : 80227-5009
Country : US
Telephone Number : 303-231-0090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 11/27/2023

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