Individual
AMANDA FACKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2147 MAPLEWOOD DR, KNOXVILLE, TN 37920-2752
(270) 871-6976
Mailing address
2147 MAPLEWOOD DR, KNOXVILLE, TN 37920-2752
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10478
TN
1041C0700X
Clinical Social Worker
Primary
LSW0000007118
TN
Other
Enumeration date
07/02/2015
Last updated
12/08/2022
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