Individual
AMANDA LOUISE EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RMHCI
Contact information
Practice address
202 LAKE MIRIAM DR STE W6, LAKELAND, FL 33813-2179
(863) 226-5081
Mailing address
202 LAKE MIRIAM DR, LAKELAND, FL 33813-2180
(863) 816-6884
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/10/2018
Last updated
11/10/2018
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