| NPI | 1063763290 |
|---|---|
| Former Name | AMANDA MICHELE OVERCASH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20084) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 9988) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2018-12-11 |