Organization
AMITY MENTAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURI CODY (OWNER OF ENTITY)
(813) 458-7232
Entity
Organization
Contact information
Practice address
147 COMMERCIAL ST NE STE 7, SALEM, OR 97301-3418
(813) 458-7232
Mailing address
147 COMMERCIAL ST NE STE 7, SALEM, OR 97301-3418
(813) 458-7232
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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