Willis, Amy J

Willis, Amy J is an individual health care provider with primary practice located at 2603 Osborne Rd Ste E , Saint Marys GA 31558-8907. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Willis, Amy J can be contacted via phone (912) 510-3420.

Contact Information

Primary practice address
2603 Osborne Rd Ste E Saint Marys GA 31558-8907
Fax: (912) 510-3425
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LSW0000004269 Tennessee

Profile Details

NPI number 1235229980
LBN Legal business name Willis, Amy J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jun 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235229980 NPPES
Tennessee MEDICAID 3698356

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