Provider Demographics
NPI:1316799588
Name:STELLY, AMY
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:
Last Name:STELLY
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 1:3201 E FORT LOWELL RD APT 2092
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1689
Mailing Address - Country:US
Mailing Address - Phone:520-820-8073
Mailing Address - Fax:
Practice Address - Street 1:6700 E SPEEDWAY BLVD STE 401
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1220
Practice Address - Country:US
Practice Address - Phone:520-448-9005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician