Provider Demographics
NPI:1174951479
Name:REMINGTON, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2047
Mailing Address - Country:US
Mailing Address - Phone:402-641-6245
Mailing Address - Fax:402-646-2045
Practice Address - Street 1:905 MAIN ST
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2047
Practice Address - Country:US
Practice Address - Phone:402-641-6245
Practice Address - Fax:402-646-2045
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1044101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)