Provider Demographics
NPI:1558006403
Name:FERRELL, AMY LAURA (MS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LAURA
Last Name:FERRELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 QUAIL RUN WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-4107
Mailing Address - Country:US
Mailing Address - Phone:859-489-0778
Mailing Address - Fax:
Practice Address - Street 1:1724 QUAIL RUN WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-4107
Practice Address - Country:US
Practice Address - Phone:859-489-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health