Healthcare Provider Details

I. General information

NPI: 1033272356
Provider Name (Legal Business Name): AMY B ADLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CMR 442
APO AE
09042-0130
US

IV. Provider business mailing address

503 ROBERT GRANT AVE RM 1W30 WRAIR - OFFICE OF RESEARCH MANAGEMENT
SILVER SPRING MD
20910-7500
US

V. Phone/Fax

Practice location:
  • Phone: 314-371-2626
  • Fax:
Mailing address:
  • Phone: 301-319-9940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number696
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: