Individual
AMANDA ZICCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 WAYMONT CT STE 100, LAKE MARY, FL 32746-3475
(407) 635-1979
Mailing address
633 SABAL LAKE DR APT 205, LONGWOOD, FL 32779-6048
(914) 564-9510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH27024
FL
Other
Enumeration date
07/05/2022
Last updated
01/10/2025
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