Individual
AMANDA LEANN PHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
606 E SPRING ST STE 100, COOKEVILLE, TN 38501-5067
(931) 526-6042
Mailing address
PO BOX 2241, COOKEVILLE, TN 38502-2241
(931) 267-1663
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
7879
TN
101YM0800X
Mental Health Counselor
Primary
7879
TN
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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