Provider Demographics
NPI:1548568454
Name:HECTOR, AMANDA SOUTHER (LPCA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:SOUTHER
Last Name:HECTOR
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 LENOIR-RHYNE BOULEVARD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602
Mailing Address - Country:US
Mailing Address - Phone:828-322-3988
Mailing Address - Fax:828-322-3684
Practice Address - Street 1:336 LENOIR-RHYNE BOULEVARD
Practice Address - Street 2:SUITE 1
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-322-3988
Practice Address - Fax:828-322-3684
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional