Provider Demographics
NPI:1104350107
Name:CAMADECO, AMY MARIE
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:MARIE
Last Name:CAMADECO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 COLLEGE DR APT 413
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7585
Mailing Address - Country:US
Mailing Address - Phone:702-466-3895
Mailing Address - Fax:
Practice Address - Street 1:6600 W CHARLESTON #140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-437-4673
Practice Address - Fax:702-438-4673
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health