Healthcare Provider Details
I. General information
NPI: 1740852250
Provider Name (Legal Business Name): AMANDA PAIGE HOHLY-SENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2021
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
97 S 4TH ST STE A
ISHPEMING MI
49849-2168
US
IV. Provider business mailing address
97 S 4TH ST STE C
ISHPEMING MI
49849-2168
US
V. Phone/Fax
- Phone: 906-228-9699
- Fax:
- Phone: 906-228-9699
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: