Provider Demographics
NPI:1508521063
Name:TULLY, AMY W (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:W
Last Name:TULLY
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 1:10 ROSS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1078
Mailing Address - Country:US
Mailing Address - Phone:845-486-6330
Mailing Address - Fax:
Practice Address - Street 1:DUTCHESS CLINIC OF ROCKLAND PSYCHIATRIC CENTER
Practice Address - Street 2:10 ROSS CIRCLE
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-486-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021397103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling