=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912403841
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY C HUFF
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2018
-----------------------------------------------------
Last Update Date | 03/31/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 W GRAND RIVER AVE
-----------------------------------------------------
City | FOWLERVILLE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48836-9417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-223-1393
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 622 E GRAND RIVER AVE
-----------------------------------------------------
City | HOWELL
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48843-2329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-548-0081
-----------------------------------------------------
Fax | 517-546-1300
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------