Provider Demographics
NPI:1093599581
Name:AMANDA DOBLER COUNSELING, LLC
Entity Type:Organization
Organization Name:AMANDA DOBLER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIESKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-716-2693
Mailing Address - Street 1:PO BOX 354
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32588-0354
Mailing Address - Country:US
Mailing Address - Phone:850-737-3379
Mailing Address - Fax:850-273-5511
Practice Address - Street 1:111 BAILEY DR STE 2
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2755
Practice Address - Country:US
Practice Address - Phone:850-737-3379
Practice Address - Fax:850-273-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty