Masellis, Amanda Liesta
Masellis, Amanda Liesta is an sole proprietor health care provider with primary practice located at 164 E 5900 S Ste 101 , Murray UT 84107-7256. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Masellis, Amanda Liesta can be contacted via phone (801) 261-5790.Contact Information
Primary practice address
164 E 5900 S Ste 101
Murray UT 84107-7256
Phone: (801) 261-5790
Fax: (801) 261-5794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CI10940218 | California |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 11822780-6006 | Utah |
Profile Details
| NPI number | 1851742001 |
|---|---|
| LBN Legal business name | Masellis, Amanda Liesta |
| Credentials | CADC-I, SUDC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2016 |
| Last updated | Nov 6th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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