Healthcare Provider Details

I. General information

NPI: 1205496833
Provider Name (Legal Business Name): AMY LYNN FINKEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LYNN FINKEL-NITSCHKE

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 E 13 MILE RD # 200
WARREN MI
48093-3093
US

IV. Provider business mailing address

12200 E 13 MILE RD # 200
WARREN MI
48093-3093
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-1810
  • Fax:
Mailing address:
  • Phone: 586-573-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401002113
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: