Provider Demographics
NPI:1205031903
Name:AMAR, ALIX (MED MSS)
Entity Type:Individual
Prefix:MS
First Name:ALIX
Middle Name:
Last Name:AMAR
Suffix:
Gender:F
Credentials:MED MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7823 MILL RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2745
Mailing Address - Country:US
Mailing Address - Phone:215-391-0996
Mailing Address - Fax:
Practice Address - Street 1:7823 MILL RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2745
Practice Address - Country:US
Practice Address - Phone:215-391-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2015-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0140841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical