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General NPI Number Information
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NPI Number | 1053026930
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Entity Type | Organization
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Legal Business Name | AMALY
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 2615 SWEETWATER SPRINGS BLVD STE G
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1725
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Country | US
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Telephone | 760-498-4160
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Fax |
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Provider Business Mailing Address
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Address Line | 2615 SWEETWATER SPRINGS BLVD STE G48
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-CEO
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Name | MISS HALIMA EID
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Credential | LPCC
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Telephone | 619-841-1457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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