Provider Demographics
NPI:1679231526
Name:MATHER, AMY JEANNINE (MSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JEANNINE
Last Name:MATHER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JEANNINE
Other - Last Name:DRAWVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1576 BARKING DEER CV
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5843
Mailing Address - Country:US
Mailing Address - Phone:407-283-4186
Mailing Address - Fax:
Practice Address - Street 1:1576 BARKING DEER CV
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5843
Practice Address - Country:US
Practice Address - Phone:407-283-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL183451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical