Individual
AMANDA IVKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2909 W BAY TO BAY BLVD, SUITE 200, TAMPA, FL 33629-8100
(813) 381-5200
Mailing address
5501 W WATERS AVE, SUITE 406, TAMPA, FL 33634-1229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
MH14091
FL
Other
Enumeration date
08/07/2014
Last updated
06/29/2016
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