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General NPI Number Information
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NPI Number | 1265819932
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Entity Type | Individual
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Provider Name | AMBER NANGLE M.S.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 10810 BOYETTE RD # 2673
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City | RIVERVIEW
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State | FL
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Zip | 33569-8000
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Country | US
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Telephone | 813-525-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 10810 BOYETTE RD # 2673
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City | RIVERVIEW
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State | FL
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Zip | 33569-8000
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Country | US
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Telephone |
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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 | IMH 11911
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13957
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License Number State | FL
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