Healthcare Provider Details

I. General information

NPI: 1265265649
Provider Name (Legal Business Name): VICTORIA AMPARO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S SEMORAN BLVD STE A
ORLANDO FL
32807-1424
US

IV. Provider business mailing address

3508 WINDY WALK WAY APT 302
ORLANDO FL
32837-7343
US

V. Phone/Fax

Practice location:
  • Phone: 407-704-7811
  • Fax:
Mailing address:
  • Phone: 201-754-3864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: