Individual
AMANDA MAE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6460 HARRISON AVE, CINCINNATI, OH 45247-7957
(513) 941-4999
(513) 694-0168
Mailing address
6460 HARRISON AVE STE 200, CINCINNATI, OH 45247-7958
(513) 941-4999
(513) 694-0168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.160110
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.162617
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.161747
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162280
OH
101YP2500X
Professional Counselor
C.2305437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0267573
—
OH
Enumeration date
06/21/2016
Last updated
12/12/2024
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