Individual
AMANDA JEANETTE LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AS, CDCA
Contact information
Practice address
602 S SOUTH ST, WILMINGTON, OH 45177-2791
(937) 414-2016
Mailing address
602 S SOUTH ST, WILMINGTON, OH 45177-2791
(937) 414-2016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.178529
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/27/2021
Last updated
02/18/2025
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