Individual
AMANDA M LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDCII
Contact information
Practice address
320 W MAIN ST, MC ARTHUR, OH 45651-1015
(740) 596-2542
(740) 596-2516
Mailing address
224 COLUMBUS RD, ATHENS, OH 45701-1334
(740) 592-6724
(740) 592-6728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
161334
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864002
—
OH
Enumeration date
04/10/2018
Last updated
06/16/2018
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