Provider Demographics
NPI:1073164232
Name:DEMARS, AMBER MARIE (MED NCC ALC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:DEMARS
Suffix:
Gender:F
Credentials:MED NCC ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 OPELIKA RD APT 122
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3927
Mailing Address - Country:US
Mailing Address - Phone:334-332-7147
Mailing Address - Fax:
Practice Address - Street 1:1109 SPRING DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5345
Practice Address - Country:US
Practice Address - Phone:334-745-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2988A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor