Healthcare Provider Details

I. General information

NPI: 1447681663
Provider Name (Legal Business Name): AMANDA SUMMEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 CLEVELAND HWY
DALTON GA
30721-8160
US

IV. Provider business mailing address

2611 CLEVELAND HWY
DALTON GA
30721-8160
US

V. Phone/Fax

Practice location:
  • Phone: 706-934-8807
  • Fax:
Mailing address:
  • Phone: 706-934-8807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: