Individual
AMANDA ROZENA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 BURLINGTON RD STE 240, JACKSON, OH 45640-9360
(740) 286-5075
(740) 395-8411
Mailing address
3086 STATE ROUTE 160, GALLIPOLIS, OH 45631-8409
(740) 446-5500
(740) 446-2159
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
APP-000074679
OH
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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