Provider Demographics
NPI:1245940022
Name:AMORY PSYCHIATRY AND WELLNESS
Entity type:Organization
Organization Name:AMORY PSYCHIATRY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COSMA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:330-205-1168
Mailing Address - Street 1:11911 BOWER RD
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-9603
Mailing Address - Country:US
Mailing Address - Phone:330-205-1168
Mailing Address - Fax:614-987-8883
Practice Address - Street 1:11911 BOWER RD
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-9603
Practice Address - Country:US
Practice Address - Phone:330-205-1168
Practice Address - Fax:614-987-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty