Provider Demographics
NPI:1740539667
Name:SCHULLERY, AMY (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:SCHULLERY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 REGENCY PLZ
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1001
Mailing Address - Country:US
Mailing Address - Phone:610-635-9641
Mailing Address - Fax:
Practice Address - Street 1:1515 WEST CHESTER PIKE, C-2
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382
Practice Address - Country:US
Practice Address - Phone:610-635-9641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016686103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist