Provider Demographics
NPI:1962016881
Name:AMANIMAA, MERCY ADJOA (BSW)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:ADJOA
Last Name:AMANIMAA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:ADJOA
Other - Last Name:AMANIMAA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:QHMS
Mailing Address - Street 1:515 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3455
Mailing Address - Country:US
Mailing Address - Phone:513-868-7654
Mailing Address - Fax:513-737-0026
Practice Address - Street 1:515 DAYTON ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3455
Practice Address - Country:US
Practice Address - Phone:513-868-7654
Practice Address - Fax:513-737-0026
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA104100000X104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker