Individual
AMBER STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
403 PRINCETON RD STE 2, JOHNSON CITY, TN 37601-2040
(423) 297-8351
Mailing address
393 MAX JETT RD, JOHNSON CITY, TN 37601-6265
(423) 502-2869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000006334
TN
Other
Enumeration date
07/11/2016
Last updated
08/11/2016
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