Provider Demographics
NPI:1205394806
Name:HIRNEISE, AMMY WALTERSCHEID
Entity Type:Individual
Prefix:
First Name:AMMY
Middle Name:WALTERSCHEID
Last Name:HIRNEISE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 BELMEADE LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3477
Mailing Address - Country:US
Mailing Address - Phone:940-736-4211
Mailing Address - Fax:
Practice Address - Street 1:709 BELMEADE LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3477
Practice Address - Country:US
Practice Address - Phone:940-736-4211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty