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Individual
AMANDA ACTOR
Active
Individual
AMANDA ACTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
71256
TN
2084P0805X
Geriatric Psychiatry Physician
Primary
71256
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2020
Last updated
08/25/2025
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