Provider Demographics
NPI:1770928863
Name:DOUGLAS, AMBER N (PHD)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:N
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COLLEGE ST
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-1423
Mailing Address - Country:US
Mailing Address - Phone:413-538-2086
Mailing Address - Fax:
Practice Address - Street 1:135 HICKS WAY
Practice Address - Street 2:123 TOBIN HALL, PSYCHOLOGICAL SERVICES CENTER
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9271
Practice Address - Country:US
Practice Address - Phone:413-545-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health