Provider Demographics
NPI:1689129132
Name:SHOWALTER, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:STAPLETON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:553 FRENCH LN
Mailing Address - Street 2:
Mailing Address - City:DUNDAS
Mailing Address - State:MN
Mailing Address - Zip Code:55019-3975
Mailing Address - Country:US
Mailing Address - Phone:507-269-7486
Mailing Address - Fax:
Practice Address - Street 1:1001 14TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2590
Practice Address - Country:US
Practice Address - Phone:507-269-7486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist