Provider Demographics
NPI:1952669061
Name:PLANTE, AMY A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:A
Last Name:PLANTE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ALEWIFE BROOK PARKWAY
Mailing Address - Street 2:SUITE 416
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-869-6662
Mailing Address - Fax:
Practice Address - Street 1:185 ALEWIFE BROOK PARKWAY
Practice Address - Street 2:SUITE 416
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-869-6662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1970103TB0200X
MA9170103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral