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General NPI Number Information
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NPI Number | 1821588021
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Entity Type | Individual
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Provider Name | AMELIA E. TUTTLE MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 23 LENOX POINTE NE
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City | ATLANTA
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State | GA
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Zip | 30324-3172
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Country | US
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Telephone | 678-242-9472
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Fax |
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Provider Business Mailing Address
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Address Line | 935 BLUE RIDGE AVE NE APT 5
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City | ATLANTA
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State | GA
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Zip | 30306-4416
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Country | US
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Telephone | 703-402-4063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT001594
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License Number State | GA
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