Provider Information for 1770923955
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AMBER LIA BENAMOU LCSW
Sex: Female
NPI: 1770923955
Last Updated: 2015-06-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1770923955 | ||||||||||||
| Enumeration Date | 2013-07-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4740 N STATE ROAD 7 201 LAUDERDALE LAKES, FL 33319-5839 United States Phone: 954-486-4005 | Fax:954-497-3857 | ||||||||||||
| Primary Practice Address | 2900 W PROSPECT RD FORT LAUDERDALE, FL 33309-2519 United States Phone: 954-731-5100 | Fax:954-497-3857 | ||||||||||||
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