Individual
MRS. AMANDA PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S, LICDC
Contact information
Practice address
11611 STATE ROUTE 771, LEESBURG, OH 45135-8601
(937) 780-2221
Mailing address
11611 STATE ROUTE 771, LEESBURG, OH 45135-8601
(937) 780-2221
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161958
OH
1041C0700X
Clinical Social Worker
Primary
I.1700528
OH
Other
Enumeration date
08/30/2017
Last updated
08/18/2021
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