Individual
AMBER BRISA MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RMHCI
Contact information
Practice address
922 SW BAYA DR, LAKE CITY, FL 32025-4209
(386) 754-9005
(386) 754-9017
Mailing address
20251 E LEVY ST, WILLISTON, FL 32696-7375
(508) 254-5807
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH11197
FL
Other
Enumeration date
10/31/2013
Last updated
10/31/2013
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