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NPI Code Detail

MEDICARE: DONALD B AMICO

MEDICARE:   DONALD B AMICO
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1730477175
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD B AMICO
Provider Business Mailing Address
First Line : 8440 WESTCLIFF DR
Second Line : 1084
City : LAS VEGAS
State : NV
Zip : 89145-5601
Country : US
Telephone Number : 702-979-0082
Fax Number :
Provider Business Practice Location Address
First Line : 5465 REFLEX DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89156-4606
Country : US
Telephone Number : 702-979-0082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2011
Last Update Date : 07/19/2011

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Directions to “ DONALD B AMICO ” Practice Location

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