Provider Demographics
NPI:1609804889
Name:ARNOLD, AMY ELIZABETH (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:YOUATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:705 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1060
Mailing Address - Country:US
Mailing Address - Phone:734-452-0800
Mailing Address - Fax:734-451-0813
Practice Address - Street 1:705 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1060
Practice Address - Country:US
Practice Address - Phone:734-452-0800
Practice Address - Fax:734-451-0813
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000026231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1609804889Medicaid
MI1609804889Medicaid
MIN71920009Medicare PIN