Provider Demographics
NPI:1265223168
Name:TODD, AMI
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:TODD
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 1:107 TOMMY HENRICH DR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-5402
Mailing Address - Country:US
Mailing Address - Phone:330-832-9582
Mailing Address - Fax:330-466-4986
Practice Address - Street 1:107 TOMMY HENRICH DR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-5402
Practice Address - Country:US
Practice Address - Phone:330-832-9582
Practice Address - Fax:330-466-4986
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health