Provider Demographics
NPI:1609181023
Name:WOLTER, AMELIA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:
Last Name:WOLTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 QUINTANA PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2356
Mailing Address - Country:US
Mailing Address - Phone:561-504-9182
Mailing Address - Fax:
Practice Address - Street 1:6480 QUINTANA PL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2356
Practice Address - Country:US
Practice Address - Phone:561-504-9182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMFT2714106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist