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Individual

AMANDA D BISHOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
711 SCHOLL RD, MANSFIELD, OH 44907-1571
(419) 526-6102
Mailing address
741 SCHOLL RD, MANSFIELD, OH 44907-1571
(419) 756-1717

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S.2309061
LSW LICENSE
OH
Enumeration date
01/21/2021
Last updated
05/12/2023
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