Provider Demographics
NPI:1275668873
Name:BESSEY, AMANDA SHEYENNE (LMT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:SHEYENNE
Last Name:BESSEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 GORDON SMITH BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-827-0747
Mailing Address - Fax:
Practice Address - Street 1:415 GLENSPRINGS DR STE 305
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-2354
Practice Address - Country:US
Practice Address - Phone:513-851-8686
Practice Address - Fax:513-851-8786
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33-015584225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist