MEDICARE: MRS. AMY ALISON CHEUNG

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
1	1041C0700X	Clinical Social Worker	3970	KS

General Provider Information

NPI Number	:	1982917407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY ALISON CHEUNG

Provider Business Mailing Address
First Line	:	155 S 18TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5642
Country	:	US
Telephone Number	:	913-342-5367
Fax Number	:	913-342-4463

Provider Business Practice Location Address
First Line	:	155 S 18TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5642
Country	:	US
Telephone Number	:	913-342-5367
Fax Number	:	913-342-4463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	07/26/2010

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