Provider Demographics
NPI:1225779911
Name:RIMMER, AMANDA DANIELLA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:DANIELLA
Last Name:RIMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AYDEN
Other - Middle Name:MATTHEW
Other - Last Name:RIMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:669 RAYMOND LOOP
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-2899
Mailing Address - Country:US
Mailing Address - Phone:863-838-8805
Mailing Address - Fax:
Practice Address - Street 1:669 RAYMOND LOOP
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-2899
Practice Address - Country:US
Practice Address - Phone:863-838-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst