Amanda Proctor, LICSW
Social Worker, Clinical in Boston, MA. Individual provider (NPI-1).
NPI number1063908804
StatusActive
Last updated in NPPESJul 5, 2018
Details
- NPI
- 1063908804
- Entity type
- Individual (NPI-1)
- Name
- Amanda Proctor
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2018
- Last updated
- Jul 5, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 119906 | MA | Yes |
Practice location
105 Chauncy St Ste 302Boston, MA 02111-1771
Phone 617-879-8361
Mailing address
232 Mystic StArlington, MA 02474-1102
Phone 203-451-5509
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