Basic Information
| Provider Information | |||||||||
| NPI: | 1023448990 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TERMINA | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | CSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 SE 5TH AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334835172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619002498 | ||||||||
| FaxNumber: | 8889724762 | ||||||||
| Practice Location | |||||||||
| Address1: | 12121 RICHMOND AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770822432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8327978405 | ||||||||
| FaxNumber: | 8324910322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2013 | ||||||||
| LastUpdateDate: | 04/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.