Individual
AMANDA PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2013 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5307
(866) 610-0580
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(866) 610-0580
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009093700
—
FL
Enumeration date
11/06/2017
Last updated
03/17/2018
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