Provider Demographics
NPI:1598009920
Name:AMADEU, ANA LUISA O (MA)
Entity Type:Individual
Prefix:MS
First Name:ANA LUISA
Middle Name:O
Last Name:AMADEU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 N MAIN ST
Mailing Address - Street 2:SUITE202
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2983
Mailing Address - Country:US
Mailing Address - Phone:508-324-1060
Mailing Address - Fax:
Practice Address - Street 1:1563 N. MAIN STREET,SUITE 202
Practice Address - Street 2:SOUTH BAY
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720
Practice Address - Country:US
Practice Address - Phone:508-324-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health