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General NPI Number Information
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NPI Number | 1629714480
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Entity Type | Individual
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Provider Name | AMANDA MCINTIRE
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Gender | Female
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 400 E STATE ST STE D
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City | ATHENS
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State | OH
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Zip | 45701-1870
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Country | US
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Telephone | 740-326-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 507 MITCHELL AVE
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City | MOUNT VERNON
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State | OH
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Zip | 43050-8064
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Country | US
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Telephone | 740-398-7830
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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