Provider Demographics
NPI:1558796748
Name:DISHNER, AMANDA E (MA, LMFT-S)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:E
Last Name:DISHNER
Suffix:
Gender:F
Credentials:MA, LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 WILLAMETTE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2256
Mailing Address - Country:US
Mailing Address - Phone:512-298-2174
Mailing Address - Fax:
Practice Address - Street 1:6819 WILLAMETTE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2256
Practice Address - Country:US
Practice Address - Phone:512-298-2174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201978106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist