Provider Demographics
NPI:1194879593
Name:FISCH, AMY MUNTZ (PHD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MUNTZ
Last Name:FISCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4087 E EASTMOOR ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65809
Mailing Address - Country:US
Mailing Address - Phone:417-414-9641
Mailing Address - Fax:
Practice Address - Street 1:1901 E BENNETT ST STE H
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1434
Practice Address - Country:US
Practice Address - Phone:417-414-9641
Practice Address - Fax:703-991-0884
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010019908103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical