Amanda Christine Bantz, LCSW
Social Worker, Clinical in Columbia, MO. Individual provider (NPI-1).
NPI number1114293248
StatusActive
Last updated in NPPESMar 22, 2012
Details
- NPI
- 1114293248
- Entity type
- Individual (NPI-1)
- Name
- Amanda Christine Bantz
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 22, 2012
- Last updated
- Mar 22, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 2011037451 | MO | Yes |
Practice location
18 Clinton Dr.Columbia, MO 65203
Phone 573-529-0672
Mailing address
18 Clinton DrColumbia, MO 65203-2107
Phone 573-529-0672
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