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General NPI Number Information
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NPI Number | 1366811432
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Entity Type | Organization
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Legal Business Name | AMY L CHATELAIN PC
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 2001 PINE LAKE RD STE 350
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City | LINCOLN
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State | NE
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Zip | 68512-3651
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Country | US
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Telephone | 402-540-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 PINE LAKE RD STE 350
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City | LINCOLN
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State | NE
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Zip | 68512-3651
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Country | US
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Telephone | 402-540-4988
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMY CHATELAIN
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Credential | PHD
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Telephone | 402-540-4988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 793
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License Number State | NE
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