Provider Demographics
NPI:1013379908
Name:REEDINGER, AMANDA OVERCASH (LAPC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:OVERCASH
Last Name:REEDINGER
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 RIDGEFAIR DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1534
Mailing Address - Country:US
Mailing Address - Phone:678-451-8638
Mailing Address - Fax:
Practice Address - Street 1:327 DAHLONEGA ST
Practice Address - Street 2:SUITE 902B
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2480
Practice Address - Country:US
Practice Address - Phone:678-983-8993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health