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NPI Code Detail

MEDICARE: AMELIA MIDDLEBROOKS

MEDICARE:   AMELIA  MIDDLEBROOKS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1861146854
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA MIDDLEBROOKS
Provider Business Mailing Address
First Line : 110 CENTERVIEW DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-8432
Country : US
Telephone Number : 843-259-2456
Fax Number :
Provider Business Practice Location Address
First Line : 110 CENTERVIEW DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-8432
Country : US
Telephone Number : 843-259-2456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2022
Last Update Date : 01/20/2026

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Directions to “ AMELIA MIDDLEBROOKS ” Practice Location

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