Individual
LISA SELVIG AMATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1538 THE GREENS WAY, SUITE 101, JACKSONVILLE BEACH, FL 32250-2499
(904) 543-0161
Mailing address
1685 BLUE HERON LN, JACKSONVILLE BEACH, FL 32250-2562
(904) 270-0743
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY6944
FL
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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