Individual
AMENIAH V. BERNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
517 JUNIPER DR, O FALLON, IL 62269-3310
(618) 530-8822
(618) 682-6182
Mailing address
517 JUNIPER DR, O FALLON, IL 62269-3310
(618) 530-8822
(618) 682-6182
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29861
IL
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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