Provider Demographics
NPI:1093363533
Name:THWREATT, AMY BETH
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:THWREATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:O'NEAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RMA
Mailing Address - Street 1:21600 OXNARD ST STE 1800
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 HAXTON DR UNIT 115
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6213
Practice Address - Country:US
Practice Address - Phone:970-305-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician