Provider Demographics
NPI:1730219601
Name:DREAN, AMY VANDERBEEK (PT)
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:VANDERBEEK
Last Name:DREAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:PRATT
Other - Last Name:VANDERBEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:29822 S WIXOM RD
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-3434
Mailing Address - Country:US
Mailing Address - Phone:248-926-5826
Mailing Address - Fax:248-926-5830
Practice Address - Street 1:29822 S WIXOM RD
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-3434
Practice Address - Country:US
Practice Address - Phone:248-926-5826
Practice Address - Fax:248-926-5830
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist