Healthcare Provider Details
I. General information
NPI: 1649833443
Provider Name (Legal Business Name): AVP ASSESSMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2019
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4851 TAMIAMI TRL N
NAPLES FL
34103-3096
US
IV. Provider business mailing address
PO BOX 8688
NAPLES FL
34101-8688
US
V. Phone/Fax
- Phone: 786-683-9811
- Fax: 800-398-9787
- Phone: 786-683-9811
- Fax: 800-398-9787
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANDREA
V
PELLEGRINNI
Title or Position: MANAGER
Credential: PSY.D.
Phone: 786-683-9811