Provider Demographics
NPI:1770880718
Name:YODER, AMANDA (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:YODER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 WESTCOTT ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-9014
Mailing Address - Country:US
Mailing Address - Phone:713-861-5656
Mailing Address - Fax:
Practice Address - Street 1:505 WESTCOTT ST
Practice Address - Street 2:SUITE 420
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-9014
Practice Address - Country:US
Practice Address - Phone:713-861-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX521331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical