| NPI | 1902170996 |
|---|---|
| Former Name | AMANDA LEE FLEMING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.0800170) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH ICDC.100327) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2013-05-08 |