Healthcare Provider Details

I. General information

NPI: 1669778924
Provider Name (Legal Business Name): AMY BETH WESNEY CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY HOCKEN

II. Dates (important events)

Enumeration Date: 02/04/2011
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5570 WHITTAKER RD
YPSILANTI MI
48197-9752
US

IV. Provider business mailing address

6550 STONY CREEK RD APT 2
YPSILANTI MI
48197-6649
US

V. Phone/Fax

Practice location:
  • Phone: 800-968-6644
  • Fax:
Mailing address:
  • Phone: 989-660-9034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: