Provider Demographics
NPI:1245563857
Name:VELEZ, AMY LEE
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:LEE
Last Name:VELEZ
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 1:6 SHERBORN CT
Mailing Address - Street 2:APT# 7
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2687
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 SHERBORN CT
Practice Address - Street 2:APT# 7
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-2687
Practice Address - Country:US
Practice Address - Phone:617-821-4028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health