Provider Demographics
NPI:1336837111
Name:TEER, AMANDA (PSYD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:TEER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:675 RIVER OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-5657
Mailing Address - Country:US
Mailing Address - Phone:770-864-2510
Mailing Address - Fax:
Practice Address - Street 1:32 LENOX POINTE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-5699
Practice Address - Country:US
Practice Address - Phone:404-590-4382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program