Individual
AMANDA BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
2317 E HOME RD, SPRINGFIELD, OH 45503-2520
(937) 390-8060
Mailing address
640 W 1ST ST, SPRINGFIELD, OH 45504-1650
(937) 624-9954
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.182887
OH
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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