Basic Information
| Provider Information | |||||||||
| NPI: | 1871662759 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SNOWDEN | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | CHANELL | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 809 N 14TH ST | ||||||||
| Address2: | |||||||||
| City: | ARKADELPHIA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719233809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702308447 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1609 PINE ST | ||||||||
| Address2: | |||||||||
| City: | ARKADELPHIA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719234428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702461109 | ||||||||
| FaxNumber: | 8702452566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 10/02/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | P0807058 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.