Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 12551 | TX |
Y | 1041C0700X | Clinical Social Worker | 62141 | TX |
NPI | 1003224999 |
---|---|
Provider Name | Amanda Lorina Cartwright |
First Address | Austin, TX 78759-8680 |
Second Address | Austin, TX 78759-8680 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 05/05/2020 |