Individual
ANNA MAMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
208 MEDICAL PARK BLVD, BRISTOL, TN 37620-7343
(423) 979-4050
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005938
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q083144
—
TN
Enumeration date
08/18/2014
Last updated
01/18/2024
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