MEDICARE: AMY JO SCHUTTE LMSW

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	104100000X	Social Worker	008021	IA

General Provider Information

NPI Number	:	1255671343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY JO SCHUTTE LMSW

Provider Business Mailing Address
First Line	:	320 N EISENHOWER AVE
Second Line	:	PO BOX 1338
City	:	MASON CITY
State	:	IA
Zip	:	50401-1521
Country	:	US
Telephone Number	:	641-424-2391
Fax Number	:	641-424-0783

Provider Business Practice Location Address
First Line	:	320 N EISENHOWER AVE
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-1521
Country	:	US
Telephone Number	:	641-424-2391
Fax Number	:	641-424-0783

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

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	08/21/2013

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