Doctor Name: | AMY PICKERING |
NPI Number: | 1154743789 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 16759 |
Business Practice Address: | 6120 Earle Brown Dr Suite Number 210 Brooklyn Center, MN - 554302123 |
Business Phone Number: | 7635600900 |
Business Fax Number: | |
Mailing Address: | 6120 Earle Brown Dr, Suite Number 210 BROOKLYN CENTER |
State: | MN |
Postal Code: | 554302123 |
Phone Number: | 7635600900 |
Fax Number: | |
NPI Enumeration Date: | 01/16/2014 |
NPI Last Update Date: | 01/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 16759 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |