Provider Demographics
NPI:1861749392
Name:WARD, AMIE LYNN
Entity type:Individual
Prefix:
First Name:AMIE
Middle Name:LYNN
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:LYNN
Other - Last Name:ZUROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1283 NASH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2339
Mailing Address - Country:US
Mailing Address - Phone:716-418-4458
Mailing Address - Fax:
Practice Address - Street 1:6395 OLD NIAGARA RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-1421
Practice Address - Country:US
Practice Address - Phone:716-433-9592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY64051101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor