Healthcare Provider Details

I. General information

NPI: 1437771789
Provider Name (Legal Business Name): AMY N FUEMMELER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY PARROTT

II. Dates (important events)

Enumeration Date: 05/09/2020
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 KELLEY PKWY
MEXICO MO
65265-3811
US

IV. Provider business mailing address

340 KELLEY PKWY
MEXICO MO
65265-3811
US

V. Phone/Fax

Practice location:
  • Phone: 735-821-2345
  • Fax: 573-582-1212
Mailing address:
  • Phone: 735-821-2345
  • Fax: 573-582-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2017030550
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: