Healthcare Provider Details

I. General information

NPI: 1558706150
Provider Name (Legal Business Name): AMEE B PATEL PH.D., M.S.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E WOODROW WILSON AVE MENTAL HEALTH CONSULTATION (116A1)
JACKSON MS
39216-5116
US

IV. Provider business mailing address

1500 E WOODROW WILSON AVE MENTAL HEALTH CONSULTATION (116A1)
JACKSON MS
39216-5116
US

V. Phone/Fax

Practice location:
  • Phone: 601-364-7871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS01364
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: