MEDICARE: AMANDA DUNCAN

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
1	101YM0800X	Mental Health Counselor	3399	TN

General Provider Information

NPI Number	:	1861865909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DUNCAN

Provider Business Mailing Address
First Line	:	2220 UNION AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-4315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 UNION AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-4315
Country	:	US
Telephone Number	:	901-561-3354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2015
Last Update Date	:	11/12/2015

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Directions to “ AMANDA DUNCAN ” Practice Location

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