Provider Demographics
NPI:1700269925
Name:PRIESTLEY, AMBER (LMFT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PRIESTLEY
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 1:916 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-2536
Mailing Address - Country:US
Mailing Address - Phone:715-531-5546
Mailing Address - Fax:
Practice Address - Street 1:582 HAYWARD AVE N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-5378
Practice Address - Country:US
Practice Address - Phone:715-531-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1011-124106H00000X
MN3432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist