Provider Demographics
NPI:1568990265
Name:RICH, AMY BETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:RICH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-2533
Mailing Address - Country:US
Mailing Address - Phone:931-273-7708
Mailing Address - Fax:
Practice Address - Street 1:13 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3307
Practice Address - Country:US
Practice Address - Phone:931-528-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health