Provider Demographics
NPI:1588111603
Name:GUNNO, AMBER ALENA (MA)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:ALENA
Last Name:GUNNO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2003
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25362
Mailing Address - Country:US
Mailing Address - Phone:304-746-2918
Mailing Address - Fax:304-746-2919
Practice Address - Street 1:713 BIGLEY AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25362
Practice Address - Country:US
Practice Address - Phone:304-746-2918
Practice Address - Fax:304-746-2919
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVE750349OtherDRIVER'S LICENSE NUMBER