Provider Demographics
NPI:1356798946
Name:NETA, AMANDA M (MSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:NETA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:SPAETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2102 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-3438
Mailing Address - Country:US
Mailing Address - Phone:715-393-9458
Mailing Address - Fax:715-298-6365
Practice Address - Street 1:2102 N 6TH ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-3438
Practice Address - Country:US
Practice Address - Phone:715-393-9458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8558-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical