Provider Demographics
NPI:1083330997
Name:PURKIS, AMY LEE (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:PURKIS
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LEE
Other - Last Name:SLYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LABA
Mailing Address - Street 1:76 ACCORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1606
Mailing Address - Country:US
Mailing Address - Phone:781-923-0900
Mailing Address - Fax:
Practice Address - Street 1:76 ACCORD PARK DR
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1606
Practice Address - Country:US
Practice Address - Phone:781-923-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA529103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst