Individual
MRS. AMBER NICOLE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SUPPORTER
Contact information
Practice address
1195 SULLIVANT AVE, COLUMBUS, OH 43223-1350
(614) 975-5849
Mailing address
640 S HAGUE AVE, COLUMBUS, OH 43204-2405
(614) 975-5849
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
SS521668
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102150043-00
—
OH
Enumeration date
01/19/2022
Last updated
01/19/2022
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