Provider Demographics
NPI:1689684276
Name:PARISH, AMY A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:A
Last Name:PARISH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 55657
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72215-5657
Mailing Address - Country:US
Mailing Address - Phone:877-414-0414
Mailing Address - Fax:817-615-9821
Practice Address - Street 1:1699 HARRISON ST STE D
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7318
Practice Address - Country:US
Practice Address - Phone:877-414-0414
Practice Address - Fax:817-615-9821
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR08-03P103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5P008Medicare PIN