Provider Demographics
NPI:1881463826
Name:BAGGIOSSI, AMANDA RENEE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:BAGGIOSSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:RENEE
Other - Last Name:SCHELLHORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2359 KNOLLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1525
Mailing Address - Country:US
Mailing Address - Phone:216-260-1405
Mailing Address - Fax:330-632-8823
Practice Address - Street 1:9500 HOWLAND SPRINGS RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-3108
Practice Address - Country:US
Practice Address - Phone:216-260-1405
Practice Address - Fax:330-632-8823
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty