Most Relevant Information
Provider Data
| NPI Number: | 1003428939 |
| Provider Name: | AMANDA PETTIT |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/21/2020 |
| Last Updated: | 08/21/2020 |
Provider Practice Location
600 WAYNE AVE
DAYTON
OH
454101122
Practice Location Phone/Fax
| Phone: | 9374962000 |
| Fax: |
Provider Mailing Location
600 WAYNE AVE
DAYTON
OH
454101122
Provider Mailing Phone/Fax
| Phone: | 9374962000 |
| Fax: |