Provider Demographics
NPI:1164529483
Name:WRABETZ, AMY BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:BETH
Last Name:WRABETZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NAVAHCS 500 N. HWY 89
Mailing Address - Street 2:MHC (116)
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86313
Mailing Address - Country:US
Mailing Address - Phone:928-776-6071
Mailing Address - Fax:928-776-6125
Practice Address - Street 1:500 N. HWY 89
Practice Address - Street 2:MHC (116)
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:928-776-6071
Practice Address - Fax:928-776-6125
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3263103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical