Provider Demographics
NPI:1013305143
Name:THOMAS, AMY KOVAC (PLPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KOVAC
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BRIERTON LN
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1972
Mailing Address - Country:US
Mailing Address - Phone:636-931-0300
Mailing Address - Fax:
Practice Address - Street 1:115 BRIERTON LN
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1972
Practice Address - Country:US
Practice Address - Phone:636-931-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional