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General NPI Number Information
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NPI Number | 1720599731
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Entity Type | Individual
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Provider Name | AMANDA MARIE MOSSING LCSW, CAP, RYT
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Gender | Female
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 1016 CLARE AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-6219
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Country | US
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Telephone | 561-779-1575
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Fax |
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Provider Business Mailing Address
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Address Line | 427 N O ST
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City | LAKE WORTH
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State | FL
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Zip | 33460-3152
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Country | US
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Telephone | 561-779-1575
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW14851
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License Number State | FL
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