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General NPI Number Information
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NPI Number | 1992901490
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Entity Type | Organization
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Legal Business Name | AMARELLO AND WEBB
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2995 N COLE RD SUITE 255
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City | BOISE
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State | ID
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Zip | 83704-5964
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Country | US
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Telephone | 208-376-0453
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Fax |
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Provider Business Mailing Address
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Address Line | 2995 N COLE RD SUITE 255
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City | BOISE
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State | ID
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Zip | 83704-5964
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Country | US
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Telephone | 208-376-0453
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. AMY AMARELLO
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Credential | PH.D.
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Telephone | 208-376-0453
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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 | 734
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License Number State | ID
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