Provider Demographics
NPI:1700654076
Name:BOSSUYT-ANDREWS, AIMEE GABRIELLE
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:GABRIELLE
Last Name:BOSSUYT-ANDREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 LACHLAN DR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5147
Mailing Address - Country:US
Mailing Address - Phone:727-234-7584
Mailing Address - Fax:
Practice Address - Street 1:7845 LACHLAN DR
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5147
Practice Address - Country:US
Practice Address - Phone:727-234-7584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health