Provider Demographics
NPI:1164994885
Name:NEWINS, AMIE R (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMIE
Middle Name:R
Last Name:NEWINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 PICTOR LANE PSYCHOLOGY BUILDING SUITE 320
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-0001
Mailing Address - Country:US
Mailing Address - Phone:407-823-1719
Mailing Address - Fax:
Practice Address - Street 1:4111 PICTOR LANE PSYCHOLOGY BUILDING SUITE 320
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-0001
Practice Address - Country:US
Practice Address - Phone:407-823-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSY9640103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical