Provider Demographics
NPI:1548770472
Name:DEMUTH, AMY WILHELM (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:WILHELM
Last Name:DEMUTH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 THE ARTS DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-3685
Mailing Address - Country:US
Mailing Address - Phone:724-747-5535
Mailing Address - Fax:
Practice Address - Street 1:1549 THE ARTS DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3685
Practice Address - Country:US
Practice Address - Phone:724-747-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst