Individual
AMANDA L DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-4880
Mailing address
5249 FERNGROVE DR, DAYTON, OH 45432-3515
(937) 266-2412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2102583
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0456414
—
OH
Enumeration date
08/19/2021
Last updated
10/07/2021
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