Amanda Dawn Self

NPI #1245815109 in Tennessee Ridge, Tennessee

Provider Information

NPI Number
1245815109
Entity Type
Individual
Name
Amanda Dawn Self
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Intermediate Care Facility, Mental Illness
Enumeration Date
Mar 12, 2021
Last Updated
Mar 12, 2021

Practice Location

Address
1330 N MAIN ST
ZIP Code
37178-4003
Phone
(888) 291-4357

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Mental Illness

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