Provider Demographics
NPI:1467285924
Name:SPEEDY, AMBER L (BSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:SPEEDY
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 W MAIN ST STE C3
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1998
Mailing Address - Country:US
Mailing Address - Phone:989-732-6761
Mailing Address - Fax:989-732-6763
Practice Address - Street 1:829 W MAIN ST STE C3
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1998
Practice Address - Country:US
Practice Address - Phone:989-732-6761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional