Healthcare Provider Details

I. General information

NPI: 1326958844
Provider Name (Legal Business Name): AMY SUZANNE MATHIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY SUZANNE WARD

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 WALNUT ST
COSHOCTON OH
43812-1655
US

IV. Provider business mailing address

610 WALNUT ST
COSHOCTON OH
43812-1655
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-0033
  • Fax:
Mailing address:
  • Phone: 740-622-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0027255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: