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
- City
- Tennessee Ridge
- State
- Tennessee
- ZIP Code
- 37178-4003
- Phone
- (888) 291-4357
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Mental Illness |
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