Basic Information
| Provider Information | |||||||||
| NPI: | 1114685872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNION | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | MSW, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55 | ||||||||
| Address2: | |||||||||
| City: | WALTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410940055 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 902 GALLIA ST | ||||||||
| Address2: | |||||||||
| City: | PORTSMOUTH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456624139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405292125 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2021 | ||||||||
| LastUpdateDate: | 12/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | N | Agencies | Case Management | 104100000X | S.2107186 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | 101YP2500X | S.2107186 | OH | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.