Provider Demographics
NPI:1013313634
Name:PRIEB, AMY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:PRIEB
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 1:5819 E LAURITE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-9026
Mailing Address - Country:US
Mailing Address - Phone:559-679-3926
Mailing Address - Fax:
Practice Address - Street 1:1615 DRAPER ST
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-1912
Practice Address - Country:US
Practice Address - Phone:559-492-0657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78334106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist