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Individual

AMANDA COCHRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDCA, QMHS

Contact information

Practice address
517 3RD AVE, CHESAPEAKE, OH 45619-1036
(740) 451-1455
Mailing address
PO BOX 108, IRONTON, OH 45638-0108
(740) 532-1613
(740) 879-0599

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.179365
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0472392
OH
Enumeration date
01/06/2022
Last updated
01/23/2024
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