Song, Amy J

Song, Amy J is an sole proprietor health care provider with primary practice located at 4700 Las Vegas Blvd N , Nellis Afb NV 89191-6600. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Song, Amy J can be contacted via phone (702) 653-2965.

Contact Information

Primary practice address
4700 Las Vegas Blvd N Nellis Afb NV 89191-6600
Phone: (702) 653-2965
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW60422621 Washington
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X MA60319179 Washington

Profile Details

NPI number 1134416324
LBN Legal business name Song, Amy J
Credentials MSW, LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2011
Last updated Jul 21st, 2022 - about 3 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 1134416324 NPPES
Washington MEDICAID 2044158

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