Doctor Name: | MS. AMBER S LIECHTY |
NPI Number: | 1013321470 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | |
Business Practice Address: | 1601 E 4th Plain Blvd Bldg 17 Ste B222 Vancouver, WA - 986613753 |
Business Phone Number: | 3603978484 |
Business Fax Number: | 3603978494 |
Mailing Address: | Po Box 1845, VANCOUVER |
State: | WA |
Postal Code: | 986681845 |
Phone Number: | 3603978484 |
Fax Number: | 3603978494 |
NPI Enumeration Date: | 06/13/2014 |
NPI Last Update Date: | 06/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |