Provider Demographics
NPI:1396042016
Name:ADUDDELL, AMANDA DANIELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DANIELLE
Last Name:ADUDDELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 52ND ST
Mailing Address - Street 2:SUITE #6
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-2500
Mailing Address - Country:US
Mailing Address - Phone:806-797-7100
Mailing Address - Fax:806-797-7101
Practice Address - Street 1:2402 52ND ST
Practice Address - Street 2:SUITE #6
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2500
Practice Address - Country:US
Practice Address - Phone:806-797-7100
Practice Address - Fax:806-797-7101
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional