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General NPI Number Information
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NPI Number | 1477011088
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Entity Type | Organization
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Legal Business Name | AFFIRMATIONS BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 224 CHESTNUT ST
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City | COSHOCTON
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State | OH
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Zip | 43812-1164
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Country | US
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Telephone | 740-705-1543
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Fax |
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Provider Business Mailing Address
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Address Line | 69902 MOUNT HERMON RD
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City | CAMBRIDGE
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State | OH
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Zip | 43725-9464
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Country | US
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Telephone | 740-705-1543
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY L GRAY
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Credential | LISW-S, LICDC-CS
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Telephone | 740-705-1543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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