Provider Demographics
NPI:1295911873
Name:BINGLE, AMY SUZANNE
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:SUZANNE
Last Name:BINGLE
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 1:1490 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3305
Mailing Address - Country:US
Mailing Address - Phone:513-887-7189
Mailing Address - Fax:513-881-7188
Practice Address - Street 1:140 BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-1627
Practice Address - Country:US
Practice Address - Phone:513-896-7780
Practice Address - Fax:513-785-2172
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator