Provider Demographics
NPI:1720876816
Name:DOERTER, AMELIA
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:DOERTER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 LIGHTWOOD KNOT RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28457-9212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5535 CURRITUCK DR STE 220
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1155
Practice Address - Country:US
Practice Address - Phone:910-251-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician