| E. Amanda Dellinger, Llc | |
|
3105 Creekside Village Dr Nw Suite 706 Kennesaw GA 30144-2394 | |
| (678) 986-1816 | |
| Not Available |
| Full Name | E. Amanda Dellinger, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3105 Creekside Village Dr Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Evelyn Amanda Dellinger (MANAGING MEMBER) |
| Authorized Official Contact | 6789861816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E. Amanda Dellinger, Llc 148 W Main St Suite 206 Cartersville GA 30120-3568 Ph: (678) 986-1816 | E. Amanda Dellinger, Llc 3105 Creekside Village Dr Nw Suite 706 Kennesaw GA 30144-2394 Ph: (678) 986-1816 |
| NPI Number | 1700104577 |
|---|---|
| Provider Enumeration Date | 05/04/2010 |
| Last Update Date | 12/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700104577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | APC002412 (Georgia) | Secondary |
| 101YP2500X | Counselor - Professional | APC002412 (Georgia) | Primary |
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