Provider Information for 1346563012
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AMANDA JORDAN CARTER MA, LPC
Sex: Female
NPI: 1346563012
Last Updated: 2010-03-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1346563012 | ||||||||
| Enumeration Date | 2010-03-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2618 MARLEIGH FARM RD NW KENNESAW, GA 30152-6520 United States Phone: 404-895-9699 | Fax:678-721-2424 | ||||||||
| Primary Practice Address | 30C FOX CHASE CARTERSVILLE, GA 30120-2491 United States Phone: 678-721-2249 | Fax:678-721-2424 | ||||||||
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