Provider Demographics
NPI:1114470721
Name:DUEDE, AMY (PSYD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DUEDE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2963 100TH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-5513
Mailing Address - Country:US
Mailing Address - Phone:515-419-2974
Mailing Address - Fax:
Practice Address - Street 1:2963 100TH ST STE 6
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-5513
Practice Address - Country:US
Practice Address - Phone:515-419-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-31
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA122860103TC0700X
OR3114103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical