Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 587 | NE |
NPI | 1114926029 |
---|---|
Provider Name | Dr. Amy T Corey |
First Address | Omaha, NE 68114-3742 |
Second Address | Omaha, NE 68114-3742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 04/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08207 | BLUE CROSS BLUE SHIELD (01) | NE |
10025000500 | (05) | NE |
553995000 | MAGELLAN BEHAVIORAL HEALT (01) | NE |
81-0622454 | APS HEALTHCARE (01) | NE |