Provider Demographics
NPI:1790832426
Name:ROWE, AMANDA R (MA LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:ROWE
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11022 S 51ST ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4308
Mailing Address - Country:US
Mailing Address - Phone:480-628-3319
Mailing Address - Fax:520-568-3392
Practice Address - Street 1:11022 S 51ST ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4308
Practice Address - Country:US
Practice Address - Phone:480-628-3319
Practice Address - Fax:520-568-3392
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZLPC-10679101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional