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Individual

MRS. AMANDA MARIA DUES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
915 MICHIGAN ST, SIDNEY, OH 45365-2401
(937) 498-2311
Mailing address
704 BITTERSWEET DR, COLDWATER, OH 45828-1403

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
COND.2018595-SP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
COND.2018595-SP
CONDITIONAL STATE LICENSE NUMBER
OH
Enumeration date
06/05/2018
Last updated
06/05/2018
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