Individual
AMY BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LICDC
Contact information
Practice address
1430 S HIGH ST, COLUMBUS, OH 43207-1045
(614) 445-8131
Mailing address
485 CHASE RD, COLUMBUS, OH 43214-1333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.1700350
OH
Other
Enumeration date
06/19/2017
Last updated
05/11/2020
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