Amanda Leann Northcutt

NPI #1679073613 in Wagoner, Oklahoma

Provider Information

NPI Number: 1679073613
Entity Type: Individual
Name: Amanda Leann Northcutt
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Feb 16, 2018
Last Updated: Feb 16, 2018

Practice Location

Address: 109 S HARRILL AVE
City: Wagoner
State: Oklahoma
ZIP Code: 74467-5317
Phone: (918) 485-0242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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