Individual
AMANDA MILLIE STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5203 MARYLAND WAY STE 104, BRENTWOOD, TN 37027-5022
(615) 560-6622
Mailing address
810 BLAKEMORE RD, DICKSON, TN 37055-3962
(615) 513-3428
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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