Provider Demographics
NPI:1003461245
Name:STENHOUSE, AMY (MS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:STENHOUSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N WHITEWATER PARK BLVD APT P103
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5672
Mailing Address - Country:US
Mailing Address - Phone:605-595-2154
Mailing Address - Fax:
Practice Address - Street 1:333 N 1ST ST STE 150
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6135
Practice Address - Country:US
Practice Address - Phone:333-115-0837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDGENP-162170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS