Individual
MRS. AMY DEBORAH IANNITELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
483 S NOVA RD, ORMOND BEACH, FL 32174-8445
(386) 676-7100
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120-9671
(386) 676-7175
(386) 676-7134
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015044900
—
FL
Enumeration date
05/05/2010
Last updated
03/22/2021
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