Provider Demographics
NPI:1003534009
Name:CONDIE, AMITY S
Entity Type:Individual
Prefix:
First Name:AMITY
Middle Name:S
Last Name:CONDIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMITY
Other - Middle Name:S
Other - Last Name:SCOVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 W INTERNATIONAL AIRPORT RD STE 17
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1168
Mailing Address - Country:US
Mailing Address - Phone:907-770-3656
Mailing Address - Fax:
Practice Address - Street 1:401 W INTERNATIONAL AIRPORT RD STE 17
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1168
Practice Address - Country:US
Practice Address - Phone:907-770-3656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor