Provider Demographics
NPI:1649577693
Name:FLOYD, AMANDA LEE (LAPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAPC, CRC
Mailing Address - Street 1:9 ASHLEY OAKS LN
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-2841
Mailing Address - Country:US
Mailing Address - Phone:678-378-5562
Mailing Address - Fax:
Practice Address - Street 1:500 LANIER AVE W
Practice Address - Street 2:STE 606A
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7636
Practice Address - Country:US
Practice Address - Phone:678-378-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional