Provider Demographics
NPI:1003359282
Name:AMARAL, AMY LYNN (MA, CRC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:AMARAL
Suffix:
Gender:F
Credentials:MA, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WAREHAM ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-2903
Mailing Address - Country:US
Mailing Address - Phone:774-222-6256
Mailing Address - Fax:
Practice Address - Street 1:255 WAREHAM ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2903
Practice Address - Country:US
Practice Address - Phone:774-222-6256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health