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NPI Code Detail

MEDICARE: MS. AMY MARIE SHULL LISW-S

MEDICARE:  MS. AMY MARIE SHULL  LISW-S
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
11041C0700XClinical Social WorkerI.1303654 SUPVOH

General Provider Information

NPI Number : 1952762023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY MARIE SHULL LISW-S
Provider Business Mailing Address
First Line : 8904 BROOKSIDE AVE
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-3139
Country : US
Telephone Number : 513-644-1030
Fax Number : 513-644-1025
Provider Business Practice Location Address
First Line : 8904 BROOKSIDE AVE
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-3139
Country : US
Telephone Number : 513-644-1030
Fax Number : 513-644-1025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2016
Last Update Date : 03/16/2016

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Directions to “ MS. AMY MARIE SHULL LISW-S” Practice Location

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