Healthcare Provider Details

I. General information

NPI: 1437390325
Provider Name (Legal Business Name): MS. AMBER L MACKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3203 BRICK CHURCH PIKE
NASHVILLE TN
37207-2800
US

IV. Provider business mailing address

3203 BRICK CHURCH PIKE
NASHVILLE TN
37207-2800
US

V. Phone/Fax

Practice location:
  • Phone: 615-262-7822
  • Fax: 615-262-7823
Mailing address:
  • Phone: 615-262-7822
  • Fax: 615-262-7823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: