Preston, Amy Nichole

Preston, Amy Nichole is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Preston, Amy Nichole can be contacted via phone (228) 863-1132.

Contact Information

Primary practice address
1600 Broad Ave Gulfport MS 39501-3603
Fax: (228) 865-1700
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1729 Mississippi

Profile Details

NPI number 1316286305
LBN Legal business name Preston, Amy Nichole
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2013
Last updated Feb 11th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316286305 NPPES
Mississippi MEDICAID 00018213

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