Individual
AMANDA HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1201 1ST ST S, WINTER HAVEN, FL 33880-3904
(863) 294-7062
Mailing address
1201 1ST ST S, WINTER HAVEN, FL 33880-3904
(863) 294-7062
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME145391
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/14/2016
Last updated
05/08/2020
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