Amy J Bruen
Individual provider Active NPI Counselor · Palatka, FL
NPI 1295428670 · NPPES record last updated May 31, 2023
Key facts
- NPI
- 1295428670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 3314 Crill Ave
Palatka, FL 32177-4162 - Phone
- (352) 374-5600
- NPI assigned
- May 31, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
3314 Crill Ave
Palatka, FL 32177-4162
Mailing address
4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600
Other providers in Palatka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.