Individual
AMY WELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5400 EDALBERT DR, CINCINNATI, OH 45239-7604
(855) 577-7284
Mailing address
719 FOUNTAIN ABBEY PL, MIAMISBURG, OH 45342-2726
(937) 776-1544
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2204690
OH
390200000X
Student in an Organized Health Care Education/Training Program
C2103316-TRNE
OH
Other
Enumeration date
06/23/2021
Last updated
07/19/2023
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