Individual
AMY L ANTONELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
3630 S PLAZA TRL STE 150A, VIRGINIA BEACH, VA 23452-3371
(757) 985-6116
Mailing address
825 WINDOM PL, VIRGINIA BEACH, VA 23454-3416
(757) 985-6116
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103542
VA
101YM0800X
Mental Health Counselor
Primary
0701010376
VA
Other
Enumeration date
03/04/2021
Last updated
04/01/2021
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