Organization Name: | AMY ANSON, PH.D., & ASSOCIATES, LLC |
NPI Number: | 1053657825 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY ANSON (PRACTICE OWNER) |
Mailing Address: | 3330 Old Glenview Rd Suite 1 Wilmette |
State: | IL US |
Postal Code: | 600912963 |
Phone Number: | 8477915078 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2012 |
NPI Last Update Date: | 01/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071-0005222 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |