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Individual

AMY LOUISE PETRILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
4018 MEDINA RD STE D, MEDINA, OH 44256-9675
(330) 722-4166
Mailing address
19016 TURKEY MEADOW LN, STRONGSVILLE, OH 44136-6449
(440) 570-7755

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.2002101
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2488428
OH
Enumeration date
09/19/2016
Last updated
09/13/2021
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