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Individual

MS. AMANDA JO SHARP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICDC, LPC

Contact information

Practice address
130 S MAIN ST STE 210, BOWLING GREEN, OH 43402-2911
(419) 807-1054
Mailing address
130 S MAIN STREET, SUITE 210, P.O. BOX 21, BOWLING GREEN, OH 43402-2911
(419) 807-1054

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162234
OH
101YM0800X
Mental Health Counselor
C.2103522
OH

Other

Enumeration date
10/06/2020
Last updated
06/30/2022
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