Individual
AMY J WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2603 OSBORNE RD STE E, SAINT MARYS, GA 31558-8907
(912) 510-3420
(912) 510-3425
Mailing address
2603 OSBORNE RD STE E, SAINT MARYS, GA 31558-8907
(912) 510-3420
(912) 510-3425
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000004269
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3698356
—
TN
Enumeration date
10/13/2006
Last updated
06/07/2022
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