Provider Demographics
NPI:1558740191
Name:AMUNDSON, AMANDA ZIAD (MSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ZIAD
Last Name:AMUNDSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:ZIAD
Other - Last Name:ABAWI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:220 SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-1653
Mailing Address - Country:US
Mailing Address - Phone:205-657-7004
Mailing Address - Fax:
Practice Address - Street 1:220 SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-1653
Practice Address - Country:US
Practice Address - Phone:205-657-7004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor