Provider Demographics
NPI:1821227521
Name:AMICO, ROSE MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:ROSE MARIE
Middle Name:
Last Name:AMICO
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 1:328 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5517
Mailing Address - Country:US
Mailing Address - Phone:561-278-0055
Mailing Address - Fax:561-274-0178
Practice Address - Street 1:328 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5517
Practice Address - Country:US
Practice Address - Phone:561-278-0055
Practice Address - Fax:561-274-0178
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1418106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist