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General NPI Number Information
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NPI Number | 1952028284
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Entity Type | Organization
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Legal Business Name | AMANDA PEREZ COUNSELING, LLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 4721 E MOODY BLVD STE 204
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City | BUNNELL
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State | FL
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Zip | 32110-7706
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Country | US
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Telephone | 386-237-8837
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Fax |
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Provider Business Mailing Address
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Address Line | 33 RED CLOVER LN
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City | PALM COAST
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State | FL
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Zip | 32164-6651
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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 | OWNER
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Name | AMANDA V PEREZ
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Credential | LMHC
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Telephone | 386-237-8837
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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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