Provider Demographics
NPI:1699826644
Name:PREISS, AMY HEMP (PHD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:HEMP
Last Name:PREISS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:HEMP
Other - Last Name:MONAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3810 MEDICAL PKWY STE 232
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4014
Mailing Address - Country:US
Mailing Address - Phone:512-407-8147
Mailing Address - Fax:866-740-4544
Practice Address - Street 1:3810 MEDICAL PKWY STE 232
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4014
Practice Address - Country:US
Practice Address - Phone:512-407-8147
Practice Address - Fax:866-740-4544
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32244103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0017KXOtherBCBS
TX610298Medicare ID - Type Unspecified