Coppola, Amanda

Coppola, Amanda is an individual health care provider with primary practice located at 145 E Edgewood Dr , Lakeland FL 33803-4014. She recently has only one registered license in Behavioral Health & Social Service Providers / Assistant Behavior Analyst, which is considered as her primary health care specialty. Coppola, Amanda can be contacted via phone (863) 619-2809.

Contact Information

Primary practice address
145 E Edgewood Dr Lakeland FL 33803-4014
Phone: (863) 619-2809
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X Florida

Profile Details

NPI number 1548738206
LBN Legal business name Coppola, Amanda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2018
Last updated Apr 8th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548738206 NPPES
Florida MEDICAID 105385500

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