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NPI Code Detail

MEDICARE: MRS. AMY MARIE MUDDIMAN

MEDICARE: MRS. AMY MARIE MUDDIMAN
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1457693905
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY MARIE MUDDIMAN
Provider Business Mailing Address
First Line : 5400 EDALBERT DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45239-7604
Country : US
Telephone Number : 513-231-5010
Fax Number : 513-231-0658
Provider Business Practice Location Address
First Line : 274 SUTTON RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-3521
Country : US
Telephone Number : 513-231-5010
Fax Number : 513-231-0658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2013
Last Update Date : 03/22/2013

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Directions to “ MRS. AMY MARIE MUDDIMAN ” Practice Location

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