Provider Demographics
NPI:1811598949
Name:PROTHO, AMY LYNN
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:PROTHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 BUTLER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-1375
Mailing Address - Country:US
Mailing Address - Phone:412-857-3717
Mailing Address - Fax:
Practice Address - Street 1:3495 BUTLER ST STE 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-1375
Practice Address - Country:US
Practice Address - Phone:412-857-3717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional