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NPI Code Detail

MEDICARE: MS. AMENA LOVE

MEDICARE:  MS. AMENA  LOVE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist167649MI

General Provider Information

NPI Number : 1417251588
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMENA LOVE
Provider Business Mailing Address
First Line : 47756 BENTLEY DR
Second Line :
City : BELLEVILLE
State : MI
Zip : 48111-1092
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12425 RACE TRACK RD
Second Line :
City : TAMPA
State : FL
Zip : 33626-3110
Country : US
Telephone Number : 734-716-3171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2011
Last Update Date : 01/05/2011

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Directions to “ MS. AMENA LOVE ” Practice Location

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