Provider Demographics
NPI:1598832255
Name:CONNERY, AMY KATHRYN (PSY D, ABPP/CN)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KATHRYN
Last Name:CONNERY
Suffix:
Gender:F
Credentials:PSY D, ABPP/CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80306-0925
Mailing Address - Country:US
Mailing Address - Phone:720-378-1224
Mailing Address - Fax:720-210-9885
Practice Address - Street 1:954 NORTH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3419
Practice Address - Country:US
Practice Address - Phone:720-378-1224
Practice Address - Fax:720-210-9885
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19276103T00000X
UT62661702501103T00000X
CO3447103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist