Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA ETHERIDGE
Active Sole ProprietorAMANDA ETHERIDGE is a Community/Behavioral Health healthcare provider located in TULSA, Oklahoma. NPI 1104123405 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · TULSA, OK
Registration Details
- NPI Number
- 1104123405
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 22, 2011 (15.42930798057 yrs)
- Last Updated
- Aug 27, 2021
- Sole Proprietor
- Yes
Practice Information
- Address
-
6202 S LEWIS AVE STE JTULSA, OK, 741361064Browse OK providers · Browse ZIP 74136
- Phone
- 9183927988
- Primary Specialty
-
Community/Behavioral Health
251S00000X
Other Community/Behavioral Health Providers in TULSA, OK
| Name | Credential | NPI |
|---|---|---|
| MRS. DANA LYNNETTE DODSON | M.ED., LPC, CMIII | 1740573252 |
| MR. CLOUD S PHILLIPS | A.A. | 1821376088 |
| MISS DORRI DONYELLE JOHNSON | — | 1851672604 |
| DEANDRA R HUNIGAN | — | 1659654275 |
| ASTOU STAR MBACKE | BHRS | 1508137688 |
| AMANDA LYNN TILLERY | — | 1912258724 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.