Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor |
NPI | 1003039512 |
---|---|
Provider Name | Mrs. Amy Lynne Crosswhite |
First Address | Gray Tn, TN 37615-6205 |
Second Address | Mountain City, TN 37683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 02/06/2021 |