Provider Demographics
NPI:1760996466
Name:KUZNIAR, AMY VIRGINIA (LPC, ATR-BC, SCL)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:VIRGINIA
Last Name:KUZNIAR
Suffix:
Gender:F
Credentials:LPC, ATR-BC, SCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WOODSIDE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT RIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48069-1041
Mailing Address - Country:US
Mailing Address - Phone:248-928-6496
Mailing Address - Fax:
Practice Address - Street 1:8 WOODSIDE PARK BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT RIDGE
Practice Address - State:MI
Practice Address - Zip Code:48069-1041
Practice Address - Country:US
Practice Address - Phone:248-928-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZA2600X
MI6401014025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical