Provider Information for 1750026068
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AMANDA DAVIS PhD, LMHC, NCC
Sex: Female
NPI: 1750026068
Last Updated: 2024-07-16
Certification Date: 2024-07-09
Certification Date: 2024-07-09
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1750026068 | ||||||||
| Enumeration Date | 2022-05-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 17 N. JEFFERSON ST. KNIGHTSTOWN, IN 46148-1258 United States Phone: 317-395-8322 | Fax: | ||||||||
| Primary Practice Address | 17 N. JEFFERSON ST. KNIGHTSTOWN, IN 46148-1258 United States Phone: 317-395-8322 | Fax: | ||||||||
| Secondary Practice Address(es) | 16 E MAIN ST | ||||||||
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