Provider Demographics
NPI:1285756833
Name:LOUIS, AMY MARIE (MHC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:LOUIS
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1806
Mailing Address - Country:US
Mailing Address - Phone:319-338-7518
Mailing Address - Fax:319-337-7999
Practice Address - Street 1:410 IOWA AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1806
Practice Address - Country:US
Practice Address - Phone:319-338-7518
Practice Address - Fax:319-337-7999
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00845101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health