Provider Demographics
NPI:1992461438
Name:KOSTER, AMY MARIE (MED, LPC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:KOSTER
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6366
Mailing Address - Country:US
Mailing Address - Phone:214-608-8797
Mailing Address - Fax:
Practice Address - Street 1:5300 TOWN AND COUNTRY BLVD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6894
Practice Address - Country:US
Practice Address - Phone:972-234-6634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional