Organization
AMY FODOR, LCSW, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY ELIZABETH FODOR LCSW (PRESIDENT)
(772) 766-2069
Entity
Organization
Contact information
Practice address
699 17TH ST, SUITE D, VERO BEACH, FL 32960-6251
(772) 766-2069
(772) 918-8468
Mailing address
801 GRANDIN AVE, SEBASTIAN, FL 32958-5125
(772) 766-2069
(772) 918-8468
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW3798
FL
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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