NPI 1245815109

Amanda Dawn Self

Practitioner Mental Illness Intermediate Care Facility Tennessee Ridge, TN

Practice location

Address: 1330 N Main St, Tennessee Ridge, TN 37178-4003
Phone: (888) 291-4357
Mailing address: 220 Mockingbird St, Erin, TN 37061-6098

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X

Other Intermediate Care Facility, Mental Illness providers in Tennessee →

Registry record

NPI: 1245815109
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Mar 2021
Record last updated: 12 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.