| Doctor Name: | AMY ROBERTS |
| NPI Number: | 1225261605 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC |
| License Number: | A0907080 |
| Business Practice Address: | 110 Skyline Dr Russellville, AR - 728013362 |
| Business Phone Number: | 4799675570 |
| Business Fax Number: | 4798905364 |
| Mailing Address: | 350 Salem Rd, Suite 1 CONWAY |
| State: | AR |
| Postal Code: | 720347525 |
| Phone Number: | 5013368300 |
| Fax Number: | 5013295508 |
| NPI Enumeration Date: | 09/01/2009 |
| NPI Last Update Date: | 07/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | A0907080 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |