Petrill, Amy Louise

Petrill, Amy Louise is an individual health care provider with primary practice located at 4018 Medina Rd Ste D , Medina OH 44256-9675. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Petrill, Amy Louise can be contacted via phone (330) 722-4166.

Contact Information

Primary practice address
4018 Medina Rd Ste D Medina OH 44256-9675
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X I.2002101 Ohio

Profile Details

NPI number 1407304470
LBN Legal business name Petrill, Amy Louise
Credentials LISW
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2016
Last updated Sep 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407304470 NPPES
Ohio MEDICAID 2488428

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