Provider Demographics
NPI:1790406957
Name:AMORMINO, ADRIANNA MARIE (BT)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:MARIE
Last Name:AMORMINO
Suffix:
Gender:F
Credentials:BT
Other - Prefix:MRS
Other - First Name:ADRIANNA
Other - Middle Name:MARIE
Other - Last Name:RACINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1500 S DOUGLAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4108
Mailing Address - Country:US
Mailing Address - Phone:844-854-1116
Mailing Address - Fax:
Practice Address - Street 1:6510 TOWN CENTER DR
Practice Address - Street 2:SUITE E
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362
Practice Address - Country:US
Practice Address - Phone:248-965-0417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician