Individual
AMANDA NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH. MSW
Contact information
Practice address
128 N 2ND ST STE 202, CLARKSVILLE, TN 37040-6460
(615) 348-5806
Mailing address
3760 TRADEWINDS TER, CLARKSVILLE, TN 37040-6303
(941) 447-8635
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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