Individual
LUIS F AMUNATEGUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3881
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(216) 383-6616
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5482
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224239
UNISON
OH
01
—
000000533011
ANTHEM
OH
05
—
2333291
—
OH
01
—
363310
WELLCARE MEDICAID
OH
01
—
680015572
RAILROAD MEDICARE
OH
01
—
7613633
AETNA
OH
Enumeration date
07/15/2006
Last updated
05/09/2011
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