Provider Demographics
NPI:1609609809
Name:AYRES, AMIEE
Entity type:Individual
Prefix:
First Name:AMIEE
Middle Name:
Last Name:AYRES
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 1:4241 W DICKMAN RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49037-7523
Mailing Address - Country:US
Mailing Address - Phone:269-967-8758
Mailing Address - Fax:
Practice Address - Street 1:1800 SOUTH 5TH STREET
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:MI
Practice Address - Zip Code:49053
Practice Address - Country:US
Practice Address - Phone:269-250-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician