Provider Demographics
NPI:1093858409
Name:AMITH, SANDY A
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:A
Last Name:AMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6075 GOLDEN GATE PKWY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-7454
Mailing Address - Country:US
Mailing Address - Phone:239-354-1425
Mailing Address - Fax:239-455-6561
Practice Address - Street 1:6075 GOLDEN GATE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7454
Practice Address - Country:US
Practice Address - Phone:239-354-1425
Practice Address - Fax:239-455-6561
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker