Doctor Name: | DR. AMY ALGER WILTER |
NPI Number: | 1053625822 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, LMHC |
License Number: | LH60159459 |
Business Practice Address: | 608 194th Pl Se Bothell, WA - 980129203 |
Business Phone Number: | 2066139057 |
Business Fax Number: | |
Mailing Address: | 608 194th Pl Se, BOTHELL |
State: | WA |
Postal Code: | 980129203 |
Phone Number: | 2066139057 |
Fax Number: | |
NPI Enumeration Date: | 08/03/2010 |
NPI Last Update Date: | 08/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH60159459 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |