Individual
AMANDA DANIELLE BEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1120 POLARIS PKWY STE 204, COLUMBUS, OH 43240-4042
(614) 356-8565
(614) 559-9758
Mailing address
2249 WINDSOR CHASE, COLUMBUS, OH 43235-8913
(740) 610-4023
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.2203923
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I.2203923
LISW
OH
Enumeration date
09/05/2018
Last updated
11/08/2022
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