MEDICARE: AMANDA J OSHER L.M.H.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4975	FL

General Provider Information

NPI Number	:	1720102619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA J OSHER L.M.H.C.

Provider Business Mailing Address
First Line	:	5222 NW 53RD CIR
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-3754
Country	:	US
Telephone Number	:	954-418-0358
Fax Number	:

Provider Business Practice Location Address
First Line	:	7376 NW 5TH ST
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-1605
Country	:	US
Telephone Number	:	954-415-5610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2007
Last Update Date	:	07/08/2007

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