Provider Demographics
NPI:1851718183
Name:ADAMS, AMY BETH (ME)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21578 E COUNTY ROAD 1175
Mailing Address - Street 2:
Mailing Address - City:KEOTA
Mailing Address - State:OK
Mailing Address - Zip Code:74941-6632
Mailing Address - Country:US
Mailing Address - Phone:918-647-7613
Mailing Address - Fax:
Practice Address - Street 1:21578 E COUNTY ROAD 1175
Practice Address - Street 2:
Practice Address - City:KEOTA
Practice Address - State:OK
Practice Address - Zip Code:74941-6632
Practice Address - Country:US
Practice Address - Phone:918-647-7613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health