Provider Demographics
NPI:1801168778
Name:ASSEMANY, AMY (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:ASSEMANY
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N MAIN ST
Mailing Address - Street 2:G 1
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1249
Mailing Address - Country:US
Mailing Address - Phone:248-921-5980
Mailing Address - Fax:734-414-8221
Practice Address - Street 1:340 N MAIN ST
Practice Address - Street 2:G 1
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1249
Practice Address - Country:US
Practice Address - Phone:248-921-5980
Practice Address - Fax:734-414-8221
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012279103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist