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General NPI Number Information
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NPI Number | 1255255261
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Entity Type | Individual
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Provider Name | AMBER RAQUEL RUA
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 12811 KENWOOD LN STE 213
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City | FORT MYERS
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State | FL
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Zip | 33907-5648
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Country | US
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Telephone | 239-537-9646
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Fax |
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Provider Business Mailing Address
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Address Line | 3244 NW 45TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33993-7903
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Country | US
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Telephone | 732-718-9434
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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