Provider Demographics
NPI:1851799860
Name:DOVER, AMY (LMFT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DOVER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 311364
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36331-1364
Mailing Address - Country:US
Mailing Address - Phone:757-515-8636
Mailing Address - Fax:
Practice Address - Street 1:526 BOLL WEEVIL CIR
Practice Address - Street 2:OFFICE B
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-4012
Practice Address - Country:US
Practice Address - Phone:757-515-8636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist