Individual
MISS AMANDA MEGAN YOUNG NIBBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
(731) 658-6113
(731) 658-1597
Mailing address
10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
(731) 658-6113
(731) 658-1597
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC7580
TN
101YM0800X
Mental Health Counselor
T-0144351
NM
101YP2500X
Professional Counselor
CCMH0217321
NM
Other
Enumeration date
10/28/2011
Last updated
11/08/2024
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