Provider Demographics
NPI:1609269695
Name:DEHMER, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DEHMER
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 1:305 KELLY CIR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-5908
Mailing Address - Country:US
Mailing Address - Phone:651-587-3983
Mailing Address - Fax:
Practice Address - Street 1:305 KELLY CIR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5908
Practice Address - Country:US
Practice Address - Phone:651-587-3983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-15
Last Update Date:2015-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer