Healthcare Provider Details

I. General information

NPI: 1144215278
Provider Name (Legal Business Name): AMY MEEK MS, LCMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 MULBERRY RD
DERBY KS
67037-3532
US

IV. Provider business mailing address

345 RIVERVIEW ST SUITE LL2
WICHITA KS
67203-4200
US

V. Phone/Fax

Practice location:
  • Phone: 316-788-4335
  • Fax: 316-262-7202
Mailing address:
  • Phone: 316-262-5253
  • Fax: 316-262-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number225
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: