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NPI Code Detail

MEDICARE: AMARA UNTALAN

MEDICARE: AMARA UNTALAN
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
1103TC1900XCounseling Psychologist303154KY

General Provider Information

NPI Number : 1083563043
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMARA UNTALAN
Provider Business Mailing Address
First Line : 2823 FRANKFORT AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2639
Country : US
Telephone Number : 502-893-0241
Fax Number :
Provider Business Practice Location Address
First Line : 2823 FRANKFORT AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2639
Country : US
Telephone Number : 502-893-0241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “ AMARA UNTALAN ” Practice Location

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