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NPI Code Detail

MEDICARE: AMANDA ELLEN MORGAN

MEDICARE: AMANDA ELLEN MORGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1720665813
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ELLEN MORGAN
Provider Business Mailing Address
First Line : 177 MOUSE CREEK RD NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3838
Country : US
Telephone Number : 423-920-6928
Fax Number :
Provider Business Practice Location Address
First Line : 177 MOUSE CREEK RD NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3838
Country : US
Telephone Number : 423-451-8747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 10/17/2024

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Directions to “ AMANDA ELLEN MORGAN ” Practice Location

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