Individual
AMANDA M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 OLD SCIOTO TRL, PORTSMOUTH, OH 45662-6642
(740) 529-0553
Mailing address
17004 STATE ROUTE 348, LUCASVILLE, OH 45648-8452
(740) 285-6163
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
164903
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0311167
—
OH
Enumeration date
02/08/2018
Last updated
04/25/2024
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