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General NPI Number Information
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NPI Number | 1699476986
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Entity Type | Organization
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Legal Business Name | PENNY AYRES-AMARE
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 3135 STATE ROAD 580 STE 13
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-4917
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Country | US
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Telephone | 630-220-9587
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 STIRLING CIR UNIT 410
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City | DUNEDIN
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State | FL
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Zip | 34698-7066
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Country | US
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Telephone | 630-220-9587
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PENNY AYRES-AMARE
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Credential | LMHC, LCPC
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Telephone | 630-220-9587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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