Provider Demographics
NPI:1215779046
Name:ARCHULETA, AMY MICHELLE (LMFT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:ARCHULETA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MICHELLE
Other - Last Name:GUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:4635 SOUTHWEST FWY STE 635
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7112
Mailing Address - Country:US
Mailing Address - Phone:325-668-0545
Mailing Address - Fax:
Practice Address - Street 1:7171 BUFFALO GAP RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5450
Practice Address - Country:US
Practice Address - Phone:325-692-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201344106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist