Individual
AMANDA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
199 S CENTRAL AVE, COLUMBUS, OH 43223-1301
(614) 274-9500
Mailing address
482 CANDLESTICK CT APT H, GALLOWAY, OH 43119-9205
(614) 900-2463
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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