Individual
AMANDA DIVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
3950 CHESTER AVE, CLEVELAND, OH 44114-4625
(216) 431-4131
(216) 431-4151
Mailing address
3950 CHESTER AVE, CLEVELAND, OH 44114-4625
(216) 431-4131
(216) 431-4151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I1501241
OH
Other
Enumeration date
04/22/2014
Last updated
08/18/2015
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