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General NPI Number Information
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NPI Number | 1932441342
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Entity Type | Organization
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Legal Business Name | AMITY PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 03/24/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 111 W ANDERSON LN SUITE D-197
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City | AUSTIN
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State | TX
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Zip | 78752-1132
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Country | US
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Telephone | 512-571-3844
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W ANDERSON LN SUITE D-197
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City | AUSTIN
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State | TX
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Zip | 78752-1132
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Country | US
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Telephone | 512-571-3844
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | LEIGH TEHNET
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Credential | LPC
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Telephone | 512-751-3844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 66543
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License Number State | TX
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