Provider Demographics
NPI:1063211746
Name:STEEN, AMANDA (LMT, CLC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:STEEN
Suffix:
Gender:
Credentials:LMT, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20068 SUMMER PL
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-6267
Mailing Address - Country:US
Mailing Address - Phone:612-708-3173
Mailing Address - Fax:
Practice Address - Street 1:20068 SUMMER PL
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-6267
Practice Address - Country:US
Practice Address - Phone:612-708-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
SDMT10688225700000X
SD374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist