Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | IC-1527 | NV |
NPI | 1003182049 |
---|---|
Provider Name | Amanda Nielsen |
First Address | Reno, NV 89509-2612 |
Second Address | Reno, NV 89502-3527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2012 |
Last Update Date | 04/03/2020 |