Individual
AMY LYNNE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC
Contact information
Practice address
495 E MAIN ST, COLUMBUS, OH 43215-5349
(614) 355-8007
(614) 355-8620
Mailing address
DEPT 781625, PO BOX 78000, DETROIT, MI 48278-1625
(614) 355-8004
(614) 355-2220
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E1100580-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
Enumeration date
12/21/2011
Last updated
06/01/2015
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