Provider Demographics
NPI:1326404120
Name:GALECIO, AMY E (LISW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:GALECIO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:RUNKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-6314
Mailing Address - Fax:319-353-7788
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-6314
Practice Address - Fax:319-353-7788
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
IA1132531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker