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Individual

AMY POPE-LATHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
100 EXECUTIVE WAY STE 200, PONTE VEDRA BEACH, FL 32082-2713
(904) 470-0503
Mailing address
100 EXECUTIVE WAY STE 200, PONTE VEDRA BEACH, FL 32082-2713
(904) 470-0503

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW15409
FL

Other

Enumeration date
05/31/2018
Last updated
12/30/2020
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