| Doctor Name: | AMY BETH VAN DE MOTTER |
| NPI Number: | 1063722494 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | LSW8586 |
| Business Practice Address: | 255 E Watt Street Alcoa, TN - 377012236 |
| Business Phone Number: | 8652731616 |
| Business Fax Number: | 8652731645 |
| Mailing Address: | 6350 W A J Hwy, Department 100 TALBOTT |
| State: | TN |
| Postal Code: | 378778605 |
| Phone Number: | 8003553565 |
| Fax Number: | 4237142355 |
| NPI Enumeration Date: | 10/19/2010 |
| NPI Last Update Date: | 10/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LSW8586 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |