Individual
AMANDA HEATHER FLANNERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, LPC, LICDC
Contact information
Practice address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-8725
Mailing address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-8725
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
140760
OH
101YM0800X
Mental Health Counselor
Primary
1600051
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0222303
—
OH
05
—
137
—
OH
Enumeration date
04/13/2016
Last updated
09/29/2023
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