Individual
AMANDA M GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
1865 N RIDGE RD E, LORAIN, OH 44055-3300
(440) 462-1538
(440) 324-0070
Mailing address
1865 N RIDGE RD E, LORAIN, OH 44055-3300
(440) 462-1538
(440) 324-0070
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.600782-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0268768
—
OH
Enumeration date
08/29/2012
Last updated
05/09/2019
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