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NPI Code Detail

MEDICARE: AMANDA CAMERON LSW

MEDICARE: AMANDA CAMERON LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerS0800875OH

General Provider Information

NPI Number : 1952751588
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CAMERON LSW
Provider Business Mailing Address
First Line : 2255 ARCADIA AVE
Second Line :
City : LIMA
State : OH
Zip : 45805-3538
Country : US
Telephone Number : 419-371-7604
Fax Number :
Provider Business Practice Location Address
First Line : 658 W MARKET ST STE 101
Second Line :
City : LIMA
State : OH
Zip : 45801-5604
Country : US
Telephone Number : 419-222-1527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2016
Last Update Date : 06/14/2016

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Directions to “ AMANDA CAMERON LSW” Practice Location

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