Individual
AMY ALEX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10722 STANDING STONE DR, WIMAUMA, FL 33598-6163
(813) 922-6215
Mailing address
2123 FLUORSHIRE DR, BRANDON, FL 33511-1314
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
663054
—
FL
Enumeration date
03/21/2017
Last updated
03/21/2017
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