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General NPI Number Information
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NPI Number | 1659092963
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Entity Type | Organization
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Legal Business Name | AMANNY WELLNESS BEHAVIORAL LLC
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 6095 ROSWELL RD STE 450
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City | ATLANTA
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State | GA
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Zip | 30328-4003
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Country | US
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Telephone | 470-260-4493
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Fax |
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Provider Business Mailing Address
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Address Line | 6095 ROSWELL RD STE 450
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City | ATLANTA
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State | GA
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Zip | 30328-4003
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Country | US
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Telephone | 470-260-4493
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Fax |
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Authorized Official
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Title or Position | RCM
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Name | ALANA WILLIAMS
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Credential |
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Telephone | 678-820-9447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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