Healthcare Provider Details

I. General information

NPI: 1700981453
Provider Name (Legal Business Name): LAURA J AMOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 RIDGE RD E
ROCHESTER NY
14621-1229
US

IV. Provider business mailing address

490 RIDGE RD E
ROCHESTER NY
14621-1229
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-2500
  • Fax: 585-922-2664
Mailing address:
  • Phone: 585-922-2500
  • Fax: 585-922-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number070190
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: