Individual
MRS. AMANDA PETRIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
250 E 5TH ST FL 15, CINCINNATI, OH 45202-4119
(216) 200-8116
Mailing address
250 E 5TH ST FL 15, CINCINNATI, OH 45202-4119
(216) 200-8116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1800880-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0277372
—
OH
01
—
I.1800880-SUPV
CSWMFT
OH
Enumeration date
06/17/2015
Last updated
04/05/2024
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