Provider Demographics
NPI:1407111743
Name:BURROWS, AMANDA E (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:BURROWS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:MARTEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1052 OAK FOREST DR STE 360
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-3713
Mailing Address - Country:US
Mailing Address - Phone:608-799-5707
Mailing Address - Fax:
Practice Address - Street 1:1052 OAK FOREST DR STE 360
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-3713
Practice Address - Country:US
Practice Address - Phone:608-799-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013143101Y00000X
WI1411226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor