| Amanda Deloach Penney, Lpc | |
|
701 E 2nd Ave Sw Suite A Rome GA 30161-6148 | |
| (706) 237-9929 | |
| Not Available |
| Full Name | Amanda Deloach Penney, Lpc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 701 E 2nd Ave Sw, Rome, Georgia |
| Authorized Official Name and Position | Amanda Penney (OWNER) |
| Authorized Official Contact | 7062379929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Deloach Penney, Lpc 701 E 2nd Ave Sw Suite A Rome GA 30161-6148 Ph: (706) 237-9929 | Amanda Deloach Penney, Lpc 701 E 2nd Ave Sw Suite A Rome GA 30161-6148 Ph: (706) 237-9929 |
| NPI Number | 1558756049 |
|---|---|
| Provider Enumeration Date | 04/01/2015 |
| Last Update Date | 04/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558756049 | NPI | - | NPPES |
| 003137062C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0004767 (Georgia) | Primary |
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