Tietjen, Amanda S

Tietjen, Amanda S is an sole proprietor health care provider with primary practice located at 430 Braddock Ave , Daytona Beach FL 32118-4616. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Tietjen, Amanda S can be contacted via phone (386) 258-1618.

Contact Information

Primary practice address
430 Braddock Ave Daytona Beach FL 32118-4616
Phone: (386) 258-1618
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1275204430
LBN Legal business name Tietjen, Amanda S
Credentials Marriage and Family Therapist (MFT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2021
Last updated Sep 27th, 2021 - about 4 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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