Individual
AMY NIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5435 CRANE RD, WEST MELBOURNE, FL 32904-2549
(321) 213-3836
Mailing address
5435 CRANE RD, WEST MELBOURNE, FL 32904-2549
(321) 213-3836
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
04/20/2022
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