Provider Demographics
NPI:1902351398
Name:STANLEY, AMBER
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:
Last Name:STANLEY
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 1:1406 HAYS ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2833
Mailing Address - Country:US
Mailing Address - Phone:850-521-0242
Mailing Address - Fax:850-521-1973
Practice Address - Street 1:1406 HAYS ST
Practice Address - Street 2:SUITE 8
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2833
Practice Address - Country:US
Practice Address - Phone:850-521-0242
Practice Address - Fax:850-521-1973
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst