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NPI Code Detail

MEDICARE: AMELIA STOCKDALE

MEDICARE: AMELIA STOCKDALE
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
1103K00000XBehavior Analyst1-15-20998OH
2103K00000XBehavior AnalystCOBA.258OH

General Provider Information

NPI Number : 1275078503
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA STOCKDALE
Provider Business Mailing Address
First Line : 333 N SUMMIT ST FL 7
Second Line :
City : TOLEDO
State : OH
Zip : 43604-1531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2105 LAWRENCE AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number : 419-291-7080
Fax Number : 419-480-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2016
Last Update Date : 07/11/2023

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Directions to “ AMELIA STOCKDALE ” Practice Location

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