Basic Information
Provider Information
NPI: 1477516821
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POST
FirstName: AMBER
MiddleName: LYNNE
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WILSON
OtherFirstName: AMBER
OtherMiddleName: LYNNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 1675 WINTER ST NE
Address2:  
City: SALEM
State: OR
PostalCode: 97303
CountryCode: US
TelephoneNumber: 5039309879
FaxNumber: 5035850212
Practice Location
Address1: 1675 WINTER ST NE
Address2:  
City: SALEM
State: OR
PostalCode: 97303
CountryCode: US
TelephoneNumber: 5035850351
FaxNumber: 5035850212
Other Information
ProviderEnumerationDate: 04/07/2006
LastUpdateDate: 01/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XT0382ORY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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