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NPI 1124368741

NPI 1124368741 : AMY S SUTTER LCSW : PETERSBURG, KY

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General NPI Number Information
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    NPI Number           |    1124368741
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    Entity Type          |    Individual 
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    Provider Name        |    AMY S SUTTER LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/19/2013
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    Last Update Date     |    02/19/2013
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Provider Practice Location Address
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    Address Line         |    2440 LAWRENCEBURG FERRY RD 
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    City                 |    PETERSBURG
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    State                |    KY
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    Zip                  |    41080-8702
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    Country              |    US
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    Telephone            |    859-445-3556
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    Fax                  |    502-567-5620
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Provider Business Mailing Address
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    Address Line         |    2440 LAWRENCEBURG FERRY RD 
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    City                 |    PETERSBURG
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    State                |    KY
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    Zip                  |    41080-8702
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    Country              |    US
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    Telephone            |    859-445-3556
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    Fax                  |    502-567-5620
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    3257
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    License Number State |    KY
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