Organization
NOURISH PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA M ROTH (OWNER)
(812) 929-4593
Entity
Organization
Contact information
Practice address
1257 MERRIMACK DR, DAVENPORT, FL 33837-4159
(812) 929-4593
(812) 961-6551
Mailing address
1257 MERRIMACK DR, DAVENPORT, FL 33837-4159
(812) 929-4593
(812) 961-6551
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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