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Individual

AMY RACHELE GROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSP, MSCMHC, RMHCI

Contact information

Practice address
1361 ROYAL PALM SQUARE BLVD STE 7, FORT MYERS, FL 33919-1001
(239) 209-5046
Mailing address
12279 GASPARILLA AVE, PUNTA GORDA, FL 33955-2208
(941) 204-9065

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH25044
FL

Other

Enumeration date
11/17/2023
Last updated
11/17/2023
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