Most Relevant Information
Provider Data
| NPI Number: | 1003424219 |
| Provider Name: | AMANDA KATE TUBB |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/14/2020 |
| Last Updated: | 07/14/2020 |
Provider Practice Location
1601 UNION AVE APT 2
FAIRFIELD
CA
945333731
Practice Location Phone/Fax
| Phone: | 7073461974 |
| Fax: |
Provider Mailing Location
1601 UNION AVE APT 2
FAIRFIELD
CA
945333731
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |