Provider Demographics
NPI:1063578078
Name:TRUESDELL, AMANDA (MA)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:TRUESDELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8027 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8003
Mailing Address - Country:US
Mailing Address - Phone:606-759-0283
Mailing Address - Fax:606-759-0283
Practice Address - Street 1:8027 MARSHALL DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8003
Practice Address - Country:US
Practice Address - Phone:606-759-0283
Practice Address - Fax:606-759-0283
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor