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Individual

AMANDA M ORTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
12550 NEW BRITTANY BLVD, FORT MYERS, FL 33907-3655
(239) 343-9180
(239) 343-9188
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9180
(239) 343-9188

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW20677
FL
104100000X
Social Worker
253831
KY
1041C0700X
Clinical Social Worker
253831
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125212600
FL
05
7100648970
KY
Enumeration date
10/08/2019
Last updated
01/22/2025
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